Association of sleep duration and weekend catch-up sleep with remnant cholesterol in Korean adults: a nationwide population-based cross-sectional study

Growing evidence suggests that inadequate sleep duration adversely affects health outcomes, including cardiovascular disease and dyslipidemia. However, the relationship between sleep duration and remnant cholesterol (remnant-C) remains poorly understood. This study evaluated whether sleep pattern is associated with remnant-C in Korean adults. In this cross-sectional study, we used data from the Korea National Health and Nutrition Examination Surveys (KNHANES) collected between 2019 and 2023, including a total of 11,364 participants. Multivariable logistic regression analyses were conducted to assess the association between sleep duration and remnant-C and to examine the potential beneficial effect of weekend catch-up sleep (WCS) on remnant-C levels. Odds ratios (ORs) and 95% confidence intervals (CIs) for high remnant-C (≥ 30 mg/dL) according to sleep duration were estimated. Compared with individuals who slept 7 h, those with shorter or longer sleep duration exhibited a significantly increased risk of high remnant-C after adjustment for confounding factors (≤ 6 h, 1.216 [1.048‒1.411]; 8 h, 1.291 [1.099‒1.516]; ≥9 h, 1.266 [1.003‒1.599], p = 0.007). When remnant-C was analyzed as a continuous variable, both the shorter and longer sleep duration groups exhibited significantly increased remnant-C levels in the fully adjusted model. Sensitivity analyses yielded consistent results. WCS > 1 h was associated with lower remnant-C levels in women. Both longer and shorter sleep durations were independently associated with elevated remnant-C levels in the Korean population. WCS may represent a potential strategy to mitigate cardiometabolic risk associated with elevated remnant-C levels resulting from inappropriate weekday sleep duration.