Cross-sectional study on the association between neutrophil-percentage-to-albumin ratio and prevalence of sleep disorders among US adults: Evidence from NHANES 2013 to 2018

Identifying key risk factors associated with sleep disorders is critical for enabling early intervention and risk stratification. The neutrophil-percentage-to-albumin ratio (NPAR), a readily available composite inflammatory indicator, demonstrates distinct advantages in disease risk assessment. Using nationally representative data from the National Health and Nutrition Examination Survey (NHANES), this groundbreaking study investigates for the first time the association between NPAR and prevalence of sleep disorders. This cross-section study analyzed data from NHANES. Weighted multi-variable logistic regression models were employed to examine the cross-sectional association between the NPAR and prevalence of sleep disorders. The relationship between these variables was further visualized using restricted cubic splines (RCS). Additionally, subgroup analyses and interaction tests conducted to assess effect modifications by key covariates. This study included 4574 participants, of these 1287 individuals (28.1%) were diagnosed with sleep disorders. The regression model showed a significant correlation between NPAR and the prevalence of sleep disorders (odds ratio (OR) = 1.076, 95% confidence interval (CI): 1.045-1.107, P < .001). This association remained robust under sequential adjustment: for demographic con-founders (OR = 1.058, 95% CI: 1.029-1.087, P < .01), and additional adjustment for socioeconomic factors (OR = 1.051, 95% CI: 1.019-1.083, P = .049). The RCS analysis further confirmed this positive correlation (p overall < 0.001). Subgroup analyses confirmed consistent associations across different demographic groups, and the association was not significantly influenced by factors other than gender. This study found a robust association between NPAR and sleep disorders, suggesting that higher NPAR levels are associated with an increased likelihood of developing sleep disorders.