Associations of Sleep Quality with Life’s Essential 8 Cardiovascular Health Score and Metabolic Syndrome Among US Adults

<b><i>Background:</i></b> Recent studies have identified a U-shaped association between sleep duration and both poor cardiovascular health (CVH) and metabolic syndrome (MetS). However, the extent to which sleep quality affects cardiometabolic health remains understudied. Here, we examined associations of sleep quality with CVH and MetS. <b><i>Methods:</i></b> In a nationally representative cross-sectional study of US adults (<i>n</i> = 3,293), we assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI), operationalized as a continuous score (range 0-23 points) and binary (good vs. poor sleep quality) variable. We derived CVH score (range 0-100 points) using the Life's Essential 8 construct, and defined MetS using the National Cholesterol Education Program Adult Treatment Panel III criteria. We examined associations via regression models, adjusting for sociodemographic and lifestyle factors. <b><i>Results:</i></b> In fully adjusted models, a 1-point higher PSQI score was associated with lower CVH scores (β -0.61; 95% CI -0.72, -0.51) and higher odds of MetS (OR 1.02; 95% CI 1.00, 1.03). Similarly, poor (vs. good) quality sleep was associated with lower CVH scores (β -4.1; 95% CI -5.4, -2.8) and higher odds of MetS (OR 1.27; 95% CI 1.04, 1.56). The associations with CVH score and MetS appeared to be driven primarily by health behaviors metrics and hypertriglyceridemia, respectively. No significant interactions were seen with age or gender. <b><i>Conclusions:</i></b> In this cross-sectional study, individuals with poor sleep quality were found to have worse CVH scores and higher odds of MetS. Future studies could explore whether strategies promoting better quality sleep would help improve CVH and prevent MetS.