Introduction: The AHA introduced the “Life’s Simple 7” guidelines. Sleep is not mentioned in these guidelines. The present analyses examine whether sleep duration is associated with each of the “Simple 7,” and whether sleep duration contributes unique variance to health over and above the “Simple 7.”
Methods: Pooled data from the 2005-2008 NHANES was used. NHANES is a nationally-representative survey conducted by the CDC. High blood pressure and high cholesterol were assessed as self-reported history. High blood sugar was assessed as measured fasting glucose ≥100 mg/dL. Low physical activity was assessed as 2000 kcal for women and >2500 kcal for men. Measured obesity was defined as ≥30 kg/m2. Current smoking was self-reported. Habitual sleep duration was assessed as self-reported weeknight sleep and categorized as Very Short (≤4h), Short (5-6h), Normal (7-8h), and long (≥9h). Overall health was rated on a 5-point scale, with Excellent, Very Good and Good coded as “Good,” and Poor and Very Poor coded as “Poor.” All analyses were weighted and adjusted for age, sex, race, education, and body mass index (except obesity analyses).
Results: Habitual sleep duration was associated with each of the components of the “Simple 7,” including high blood pressure, high cholesterol, high blood sugar, low physical activity, high calorie diet, obesity, and smoking (see Table). Further, even after adjusting for all 7 components as well as covariates, sleep duration was related to overall health, such that overall poor health was associated with both very short (OR=1.81, 95% CI[1.31-2.49], p<0.001) and short (OR=1.23, 95%CI[1.00-1.51],p<0.05) sleep duration.
Conclusions: Habitual sleep duration is a key lifestyle health behavior. It is associated with each of the components of the “Simple 7” and contributes unique variance to overall health beyond these other key indicators. Adequate sleep duration should be considered when drafting lifestyle health guidelines.