AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Sleep Duration and Cardiovascular Disease Risk Factors in United States Adults: Nationally Representative J-Curve Analysis with Racial Disparity Trends, 2010-2024
By Adjei-Sefah K, Issaka Y, Kebede Y et al.
Background: Adequate sleep was incorporated into the American Heart Association Life’s Essential 8 (LE8) framework in 2022, yet population-level dose-response evidence linking sleep duration to cardiovascular risk remains limited. Hypothesis: Both short and long sleep duration are independently associated with elevated prevalence of major cardiovascular risk factors, following a J-shaped pattern, with disproportionate burden in non-Hispanic Black adults. Methods: We analyzed 366,571 sample adults from the National Health Interview Survey (NHIS) 2010-2024 using survey-weighted methods. Sleep duration was categorized as very short (≤5 hrs), short (6 hrs), adequate (7-9 hrs, referent), and long (≥10 hrs). Weighted prevalence ratios (PR) were estimated for hypertension, diabetes, coronary heart disease (CHD), stroke, high cholesterol, and obesity across sleep categories. Temporal trends and subgroup analyses by race/ethnicity were conducted. Results: Short sleep (≤6 hrs) affected 31.8% of U.S. adults, peaking at 34.5% in 2018. Compared with adequate sleep, very short sleep (≤5 hrs) was associated with a higher prevalence of hypertension (40.1% vs 30.3%; PR 1.32), diabetes (5.3% vs 2.8%; PR 1.85), CHD (7.0% vs 4.5%; PR 1.55), and stroke (4.6% vs 2.6%; PR 1.81). Long sleep (≥10 hrs) showed a greater excess risk for diabetes (PR 2.88) and stroke (PR 3.87), consistent with reverse causality. Non-Hispanic Black adults had the highest short-sleep prevalence (41.5%), exceeding non-Hispanic White adults by 11.5 percentage points, a disparity widening from 9.5 points in 2010 to 11.9 points in 2024. Conclusion: Inadequate sleep duration is associated with substantially elevated cardiovascular risk across a consistent J-shaped pattern in 366,571 U.S. adults. Non-Hispanic Black adults bear a disproportionate and widening short-sleep burden, identifying sleep health as an equity-sensitive target for cardiovascular disease prevention.