Gender Affects the Association Between Sleep Hygiene and Metabolic Syndrome in Older Adults: A Community-Based Longitudinal Study Publisher



Sarvari M ; Sharifi Y ; Sharifi F ; Khezrpour A ; Javankiani S ; Nasrollahizadeh A ; Tavakoli H ; Ayati A ; Moodi M ; Shadman Z ; Tayebi A ; Shahrestanaki S K ; Ebrahimi P ; Pourghazi F Show All Authors
Source: Journal of Diabetes and Metabolic Disorders Published:2026

Abstract

Background: Sleep disorders and metabolic abnormalities are significant health concerns among older adults, and there is growing recognition of their potential relationship, co-occurrence, and underlying mechanisms. This study investigates the association between sleep disorders and metabolic syndrome (MetS) in a large sample of older adults. Materials and methods: A total of 1347 participants were included in this analysis from a larger sample of 1420 individuals aged 60 years and older, randomly selected through cluster sampling in Birjand, Iran. The Pittsburgh Sleep Quality Index (PSQI) was utilized to assess sleep duration, pattern, and quality using seven selected questions. The diagnosis of MetS was established based on the Adult Treatment Panel III (ATP III) criteria. Univariate and multiple logistic regression models examined the association between sleep and metabolic variables. Results: The analysis shows that among females, very good sleep quality is significantly associated with reduced odds of metabolic syndrome (OR = 0.23, 95% CI: 0.06–0.91, p = 0.036), while other categories of sleep quality, sleep duration, satisfaction, efficiency, and latency do not show significant associations. However, non-significant trends suggest that very good sleep satisfaction (OR = 0.33, 95% CI: 0.08–1.28, p = 0.111) and very good sleep efficiency (OR = 0.62, 95% CI: 0.35–1.08, p = 0.097) may have protective effects against metabolic syndrome in females. In males, none of the sleep components, including quality, duration, satisfaction, efficiency, or latency, demonstrate significant associations with metabolic syndrome. These findings suggest a stronger relationship between sleep quality and metabolic syndrome in females than in males, highlighting the importance of considering sex-specific factors in future research (Figure 1). Conclusion: Our findings suggest a strong association between poor sleep quality and MetS in older adults, particularly among women. These results underscore the importance of addressing sleep disorders as a potential strategy for preventing and managing MetS in this population. © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2026.