Associations of allostatic load with sleep apnea, insomnia, short sleep duration, and other sleep disturbances: findings from the National Health and Nutrition Examination Survey 2005 to 2008

Purpose: To examine whether allostatic load (AL), a measure of cumulative physiologic dysregulation across biological systems, was associated with sleep apnea, insomnia, and other sleep disturbances. Methods: Data from the National Health and Nutrition Examination Survey 2005-2008 were used. AL was measured using nine biomarkers representing cardiovascular, inflammatory, and metabolic system functioning. A total of 3330 US adults aged 18 years and older were included in this study. Results: The prevalence of high AL (AL score >= 3) was the highest among African Americans (26.3%), followed by Hispanic Americans (20.3%), whites (17.7%), and other racial/ethnic group (13.8%). After adjustment for sociodemographic and lifestyle factors, high AL was significantly associated with sleep apnea (odds ratio [OR], 1.92; 95% confidence interval [Cl], 1.40-2.63), snoring (OR, 2.20; 95% Cl, 1.79-2.69), snorting/stop breathing (OR, 2.16; 95% Cl, 1.46-3.21), prolonged sleep latency (OR, 1.42; 95% Cl, 1.08-1.88), short sleep duration (<6 hours) (OR, 1.35; 95% Cl, 1.00-1.82), and diagnosed sleep disorder (OR, 2.26; 95% Cl, 1.66-3.08). There was no clear evidence that observed associations varied by sociodemographic characteristics. Conclusions: This study suggests significant associations of high AL with sleep apnea, sleep apnea symptoms, insomnia component, short sleep duration, and diagnosed sleep disorder among US adults. (C) 2014 Elsevier Inc. All rights reserved.