Association of sleep duration and insomnia with metabolic syndrome and its components in the Women’s Health Initiative

Rita Peila, Xiaonan Xue, Elizabeth M.Cespedes Feliciano, Matthew Allison, Susan Sturgeon, Oleg Zaslavsky, Katie L. Stone, Heather M. Ochs-Balcom, Yasmin Mossavar-Rahmani, Tracy E. Crane, Monica Aggarwal, Sylvia Wassertheil-Smoller, Thomas E. Rohan

Research output: Contribution to journalArticlepeer-review


Background: Epidemiological evidence suggests that inadequate sleep duration and insomnia may be associated with increased risk of metabolic syndrome (MetS). However, longitudinal data with repeated measures of sleep duration and insomnia and of MetS are limited. We examined the association of sleep duration and insomnia with MetS and its components using longitudinal data from the Women’s Health Initiative (WHI). Methods: The study included postmenopausal women (ages 50–79 years) diabetes-free at enrollment in the WHI, with baseline data on sleep duration (n = 5,159), insomnia (n = 5,063), MetS, and its components. Repeated measures of self-reported sleep duration and insomnia were available from years 1 or 3 of follow-up and of the MetS components from years 3, 6 and 9. Associations were assessed using logistic regression and generalized estimating equations models, and odds ratios and 95% confidence intervals (CI) adjusted for major risk factors were calculated. Results: In cross-sectional analysis, baseline sleep duration ≥ 9 h was positively associated with MetS (OR = 1.51; 95%CI 1.12–2.04), while sleep duration of 8- < 9 h was associated with waist circumference > 88 cm and triglycerides ≥ 150 mg/dL (OR = 1.18; 95%CI 1.01–1.40 and OR = 1.23; 95%CI 1.05–1.46, respectively). Insomnia had a borderline positive association with MetS (OR = 1.14; 95%CI 0.99–1.31), and significant positive associations with waist circumference > 88 cm and glucose ≥ 100 mg/dL (OR = 1.18; 95%CI 1.03–1.34 and OR = 1.17; 95%CI 1.02–1.35, respectively). In the longitudinal analysis, change from restful sleep to insomnia over time was associated with increased odds of developing MetS (OR = 1.40; 95%CI 1.01–1.94), and of a triglyceride level ≥ 150 mg/dL (OR = 1.48; 95%CI 1.08–2.03). Conclusions: Among postmenopausal women in the WHI, sleep duration and insomnia were associated with current and future risk of MetS and some of its components.

Original languageEnglish (US)
Article number228
JournalBMC Endocrine Disorders
Issue number1
StatePublished - Dec 2022


  • Insomnia
  • Longitudinal study
  • Metabolic syndrome
  • Postmenopausal women
  • Sleep duration

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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