Improved sleep efficiency is associated with reduced cardio‐metabolic risk: Findings from the MODERN trial.

Summary: Poor sleep increases cardio‐metabolic risk, but limited information on the impact of sleep for the improvement of cardio‐metabolic health exists. This analysis examined the impact of sleep on a health and lifestyle modification programme to reduce cardio‐metabolic disease risk factors. Secondary analysis of the MODERN randomised controlled trial to reduce cardio‐metabolic risk was undertaken at baseline and 24‐month follow‐up. Participants aged 40–70 years (n = 121) with three or more cardio‐metabolic risk factors were randomised to a health and lifestyle modification intervention (n = 59) or usual care (n = 62), and underwent 7 day/night actigraphy to assess total sleep time, sleep efficiency (%), number of awakenings/night and physical activity levels. Blood pressure, blood lipid and glycaemic levels, anthropometric and diet measures were collected. The mean age was 59 ± 7 years and 37% were male. Baseline sleep measures were not different between groups. At the 24‐month follow‐up, both groups showed improvements in cardio‐metabolic risk factors, albeit the change in blood pressure was greater in the intervention compared with the usual care group (systolic blood pressure: –11 versus –4 mmHg, p =.014). There were no differences between groups for diet, physical activity or sleep parameters. An increase in sleep efficiency was independently associated with lower systolic blood pressure (β = −2.117, p =.002) and higher high‐density lipoprotein levels (β = 0.040, p =.033); an increase in total sleep time was associated with lower low‐density lipoprotein levels (β = −0.003, p =.038) at 24 months. Overall, improvement in sleep quality over time was beneficial to reduce blood pressure and lipid levels. These findings highlight sleep as a potential target to reduce cardio‐metabolic risk. [ABSTRACT FROM AUTHOR]