S2932 Association Between Sleep Patterns and Liver Steatosis and Stiffness in US Adults: Analysis From NHANES 2017–2020

Introduction: Emerging evidence suggests a potential link between sleep disturbances and liver health. This study aimed to evaluate the relationship between sleep patterns and liver stiffness as well as steatosis using data from a nationally representative U.S. population. Methods: Data from NHANES 2017–2020 were analyzed. Of 15,560 participants, individuals <18 years and those with missing liver elastography or sleep data were excluded, yielding a final sample of 8,217 adults. Liver stiffness (in kPa) and controlled attenuation parameter (CAP, in dB/m) were assessed using transient elastography. Sleep variables included weekday and weekend sleep duration, and self-reported snoring or breathing interruptions. SPSS IBM version 26.0 was used for analysis. Results: Among 8,217 participants, 50.4% were woman, 34.3% were White, and 22.6% were Hispanic. Mean liver stiffness was 6.00 ± 5.11 kPa, and mean CAP was 264 ± 63 dB/m. Average sleep duration was 7.57 hours on weekdays and 8.27 hours on weekends. There was no significant correlation between liver stiffness and sleep duration. However, CAP was inversely correlated with sleep duration on both weekdays (Pearson r = -0.058, P < 0.001) and weekends (r = -0.052, P < 0.001). No significant association was found between liver stiffness and the frequency of snoring or breathing interruptions. Notably, participants who never snored had significantly lower mean CAP values (242.8 dB/m) compared to those who snored frequently (287.2 dB/m; P < 0.05). Frequency of snorting or breathing pauses was not significantly associated with CAP. Conclusion: In this nationally representative cohort, longer sleep duration was associated with lower liver steatosis but not stiffness. Snoring frequency correlated with higher CAP values, suggesting that habitual snoring may be a marker for hepatic steatosis. Further studies are warranted to explore the mechanistic pathways linking sleep and liver health.