Background
Existing studies have demonstrated a close association between sleep duration and insulin resistance (IR), diabetes, and related metabolic disorders. The estimated glucose disposal rate (eGDR) serves as a reliable marker of IR. This study examined the association between weekday sleep duration and eGDR, and the moderating role of weekend catch-up sleep (WCS).
Methods
We analyzed data from the National Health and Nutrition Examination Survey (2009–2023) using a cross-sectional study design to examine the association between weekday sleep duration and eGDR, while further investigating the moderating role of WCS on this relationship. Restricted cubic splines (RCS) were employed to assess potential nonlinear associations between sleep duration and eGDR, with piecewise regression analyses conducted based on identified inflection points to evaluate threshold effects. Generalized linear models and multivariable regression models were used to analyze the associations between different weekday sleep duration categories, WCS, and eGDR.
Results
This analysis included 23 475 participants. RCS modeling revealed an inverted U-shaped relationship between sleep duration and eGDR, with an inflection point at 7.32 hours. Below this threshold, increased sleep improved eGDR (β=0.273, 95% CI 0.224 to 0.322, p<0.001), while exceeding it was inversely associated (β=–0.222, 95% CI –0.272 to –0.171, p<0.001). Multivariable regression showed that, for those with <7.32 hours of weekday sleep, 1–2 hours of WCS was associated with increased eGDR (β=0.296, 95% CI 0.107 to 0.484, p=0.002) compared with no WCS. The >2 hours WCS group negatively moderated the relationship between weekday sleep and eGDR (β=–0.568, 95% CI –0.970 to –0.167, p=0.005).
Conclusion
This study revealed a significant inverted U-shaped relationship between weekday sleep duration and eGDR, identifying an optimal duration of approximately 7.32 hours, and that WCS is beneficial only in moderation and specifically for those with weekday sleep debt, whereas it may be detrimental for those who already sleep sufficiently. These findings underscore the importance of personalized sleep recommendations.
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