Physicians' Academy for Cardiovascular Education

Short sleep duration aggravates mortality risk metabolic syndrome

Impact of the Metabolic Syndrome on Mortality is Modified by Objective Short Sleep Duration

Literature - Fernandez-Mendoza J, He F, LaGrotte C, et al. - J Am Heart Assoc 2017;6:e005479.


The metabolic syndrome (MetS) is associated with high healthcare costs, increased risk of all-cause mortality and sleep disordered breathing (SDB), while its association with sleep duration is less clear [1-3]. Objective short sleep duration may play a role as an effect modifier in increasing cardio-metabolic morbidity and mortality through various mechanisms, including increased cortisol, catecholaminergic activity and impaired heart rate variability [4-6]. However, studies examining this in relation to MetS have reported modest and inconsistent effects [7,8]. The subjectivity of measures of sleep is an important limitation in these studies.

In this study, the effect modification of objective sleep duration on the increased risk of all-cause and cardiovascular/cerebrovascular (CVD/CBV) mortality associated with MetS was evaluated in a random, general population sample (Penn State Adult Cohort, final n=1344, follow-up 16.6 yrs). Five cardio-metabolic components were evaluated: obesity, hypercholesterolemia, hypertriglyceridemia, glucose dysregulation and high blood pressure. For this study, a first phase was conducted by telephone interviews and in the second phase, individuals were randomly selected and studied in a sleep laboratory.

Main results


The risk of mortality associated with MetS was found to be significantly higher in individuals with objective short sleep duration. The risk was highest in those with high blood pressure and elevated fasting glucose. These findings suggest that lengthening of sleep may improve the prognosis of individuals with MetS.


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