The cardiometabolic index as a predictor of sleep disorders and mortality: A cross-sectional study

The cardiometabolic index (CMI) reflects an individual's cardiometabolic health and is linked to the risk of dyslipidemia, obesity, hyperglycemia, and hypertension. These risk factors not only increase the likelihood of cardiovascular disease but are also strongly associated with sleep issues such as sleep apnea and insomnia. However, the relationship between CMI and the risk of sleep disorders remains unclear. This study aimed to investigate the association between CMI and sleep disorder-related morbidity and mortality. This cross-sectional study utilized data from 6220 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (2007-2014). The CMI was calculated as [waist circumference (cm)/height (cm)] × [triglycerides (mmol/L)/high-density lipoprotein-C (mmol/L)], reflecting metabolic risk. Participants were categorized into 3 CMI tertiles (Q1-Q3). Based on survey data, participants were classified into sleep disorder and non-sleep disorder groups. The analysis included logistic regression, subgroup analysis, forest plots, and survival analysis. The average age of participants was 49 ± 18.00 years; 49% were male. The high-CMI group had older participants, more males, higher body mass index, higher triglycerides, and more hypertension (P < .001). Higher CMI was significantly associated with an increased risk of sleep disorders (odds ratio [OR] = 1.11, 95% CI: 1.02 to 1.21, P = .017), with the prevalence being greater in Q3 than in Q1 (OR = 1.46, 95% CI: 1.27 to 1.68, P ≤ .001). After adjusting for demographics, the association persisted (OR = 1.13, 95% CI: 1.03-1.24, P = .014). The mortality rate was also higher in the high-CMI group (P≤.001), with a 34% increased risk of death (OR = 1.34, 95% CI: 1.08-1.67, P = .021). The study found that a higher CMI is associated with increased risks of sleep disorders and mortality. Understanding this relationship may help in monitoring cardiometabolic health and assessing sleep disorder severity. CMI could serve as a cost-effective indicator for sleep disorder assessment.