Poor sleep health is associated with worse cardiometabolic risk among rural and urban schooled Nigerian adolescents

There is limited evidence on the association between sleep health and cardio-metabolic risk (CMR) in Sub-Saharan African adolescents. Using a cross-sectional design, we assessed the association between sleep health and CMR, including 900 adolescents aged 13-19, attending six rural and six urban schools, in Osun State, Nigeria. Sleep health variables included sleep quality and duration (Pittsburgh Sleep Quality Index), risk of sleep apnea (Teen STOPBANG), and daytime sleepiness (Epworth Sleepiness Scale for Children and Adolescents). A continuous CMR-score was calculated using z-scores of mean arterial pressure (MAP), body mass index (BMI), waist circumference (WC), and random blood glucose. We analysed the association between sleep health, place of residence, and CMR using generalized linear models. Urban adolescents presented worse sleep health indicators and higher BMI, WC, and CMR-score (p < 0.05). Overall, poorer sleep quality was associated with higher CMR-score (β = 0.02), BMI z-score (β = 0.04), and WC z-score (β = 0.03) (p < 0.05), and lower sleep duration with higher CMR-score (β = 0.04), BMI z-score (β = 0.11), and WC z-score (β = 0.07) (p < 0.05). Risk of sleep apnea was associated with higher CMR-score (β = 0.08), MAP z-score (β = 0.17), and WC z-score (β = 0.14) (p < 0.05). Improving the sleep health of adolescents may prevent cardiometabolic diseases later in life.