Associations Between Sleep Quality and Metabolic Syndrome in a Brazilian Population: A Primary and Cross-Sectional Study

Main Article Content

Marina Lancaster D. de Moraes Salles Nataly Garcia Lucas Fornari Laurindo Angiseli Damaceno Scanavacca Karla Regina Ezídio Ricardo José Tofano Cláudia Rucco Penteado Detregiachi Jesselina F. dos Santos Haber Mara Silva Foratto Marconatto Sandra Maria Barbalho Karina Quesada


Poor sleep quality can affect cardiovascular health and is considered a significant risk factor for the development of risk factors for Metabolic syndrome (MetS). This study aimed to investigate possible associations between sleep quality measured by the Pittsburgh Sleep Quality Index and the MetS. This was a cross-sectional that comprised data from 208 patients. Biochemical and anthropometric parameters were assessed. The identification of MetS was performed according to the International Diabetes Federation guidelines. The quantitative variables were described with the support of the BioEstat 5.3 software. To assess the association of the studied variables with the diagnosis of MetS, the Mann-Whitney and Chi-square (n x n) statistical tests were used. The level of significance considered was 5%. According to the International Diabetes Federation criteria, 111 (53,36%) men and women presented MetS. There were no statically significant differences between the groups with or without sleep disorders and the values of waist circumference (p=0.6996), high-density lipoprotein cholesterol levels (p=0.7940), triglycerides levels (p=0.8703), blood pressure values (p= 0.9851, and p=0.9795 for systolic and diastolic blood pressure, respectively), and glycemia (p=0.5351). Eighty-eight volunteers (42%) presented sleep quality dysfunction, with the highest proportion observed among individuals affected by MetS (p=0.0019). Our results indicate an association between sleep quality and the prevalence of MetS . Therefore, sleep quality could be evaluated in patients with MetS so that the therapeutic strategy would not be limited to the intervention in biochemical and anthropometric factors.

Keywords: Metabolic syndrome, sleep quality, hypertension, dyslipidemia, obesity, diabetes

Article Details

How to Cite
SALLES, Marina Lancaster D. de Moraes et al. Associations Between Sleep Quality and Metabolic Syndrome in a Brazilian Population: A Primary and Cross-Sectional Study. Medical Research Archives, [S.l.], v. 10, n. 6, july 2022. ISSN 2375-1924. Available at: <>. Date accessed: 20 apr. 2024. doi:
Research Articles


1. Singh T, Ahmed TH, Mohamed N, et al. Does Insufficient Sleep Increase the Risk of Developing Insulin Resistance: A Systematic Review. Cureus. Mar 2022;14(3):e23501. doi:10.7759/cureus.23501
2. Silva MDS, Poyares D, Silva LO, et al. Associations of the Severity of Obstructive Sleep Apnea With Age-Related Comorbidities: A Population-Based Study. Front Neurol. 2022;13:802554. doi:10.3389/fneur.2022.802554
3. Sinatora RV, Chagas EFB, Mattera FOP, et al. Relationship of Inflammatory Markers and Metabolic Syndrome in Postmenopausal Women. Metabolites. Jan 13 2022;12(1)doi:10.3390/metabo12010073
4. Tofano RJ, Pescinni-Salzedas LM, Chagas EFB, et al. Association of Metabolic Syndrome and Hyperferritinemia in Patients at Cardiovascular Risk. Diabetes, metabolic syndrome and obesity : targets and therapy. 2020;13:3239-3248. doi:10.2147/dmso.S271050
5. Silveira Rossi JL, Barbalho SM, Reverete de Araujo R, Bechara MD, Sloan KP, Sloan LA. Metabolic syndrome and cardiovascular diseases: Going beyond traditional risk factors. Diabetes Metab Res Rev. Mar 2022;38(3):e3502. doi:10.1002/dmrr.3502
6. Lavor CBH, Viana Júnior AB, Medeiros FDC. Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography. Rev Bras Ginecol Obstet. Mar 2022;44(3):287-294. Síndrome dos ovários policísticos e síndrome metabólica: Achados clínicos e laboratoriais e doença hepática gordurosa não alcoólica avaliada por elastografia. doi:10.1055/s-0041-1741032
7. Khan MS, Aouad R. The Effects of Insomnia and Sleep Loss on Cardiovascular Disease. Sleep Med Clin. Jun 2022;17(2):193-203. doi:10.1016/j.jsmc.2022.02.008
8. Gohari A, Baumann B, Jen R, Ayas N. Sleep Deficiency: Epidemiology and Effects. Clin Chest Med. Jun 2022;43(2):189-198. doi:10.1016/j.ccm.2022.02.001
9. Strack C, Behrens G, Sag S, et al. Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study. Biol Sex Differ. Mar 4 2022;13(1):8. doi:10.1186/s13293-022-00416-4
10. Pucci G, Alcidi R, Tap L, Battista F, Mattace-Raso F, Schillaci G. Sex- and gender-related prevalence, cardiovascular risk and therapeutic approach in metabolic syndrome: A review of the literature. Pharmacol Res. Jun 2017;120:34-42. doi:10.1016/j.phrs.2017.03.008
11. Gouveia É R, Gouveia BR, Marques A, et al. Predictors of Metabolic Syndrome in Adults and Older Adults from Amazonas, Brazil. Int J Environ Res Public Health. Feb 1 2021;18(3)doi:10.3390/ijerph18031303
12. Bittencourt LRA, Santos-Silva R, Taddei JA, Andersen ML, de Mello MT, Tufik S. Sleep complaints in the adult Brazilian population: a national survey based on screening questions. J Clin Sleep Med. 2009;5(5):459-463.
13. Sejbuk M, Mirończuk-Chodakowska I, Witkowska AM. Sleep Quality: A Narrative Review on Nutrition, Stimulants, and Physical Activity as Important Factors. Nutrients. May 2 2022;14(9)doi:10.3390/nu14091912
14. Nedeltcheva AV, Scheer FA. Metabolic effects of sleep disruption, links to obesity and diabetes. Curr Opin Endocrinol Diabetes Obes. Aug 2014;21(4):293-8. doi:10.1097/med.0000000000000082
15. Lo K, Woo B, Wong M, Tam W. Subjective sleep quality, blood pressure, and hypertension: a meta-analysis. J Clin Hypertens (Greenwich). Mar 2018;20(3):592-605. doi:10.1111/jch.13220
16. Barros D, García-Río F. Obstructive sleep apnea and dyslipidemia: from animal models to clinical evidence. Sleep. Mar 1 2019;42(3)doi:10.1093/sleep/zsy236
17. Dutil C, Chaput JP. Inadequate sleep as a contributor to type 2 diabetes in children and adolescents. Nutr Diabetes. May 8 2017;7(5):e266. doi:10.1038/nutd.2017.19
18. Lohman TG, Roche AF, Martorell R. Anthropometric Standardization Reference Manual. Human Kinetics Books; 1988.
19. Gibson RS, Gibson RS. Principles of Nutritional Assessment. Oxford University Press; 2005.
20. Porto CC. Semiologia medica. Guanabara Koogan; 2005.
21. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. May 2006;23(5):469-80. doi:10.1111/j.1464-5491.2006.01858.x
22. Kurisu S, Nitta K, Sumimoto Y, et al. Frontal QRS-T angle and World Health Organization classification for body mass index. Int J Cardiol. Dec 1 2018;272:185-188. doi:10.1016/j.ijcard.2018.08.060
23. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. May 1989;28(2):193-213. doi:10.1016/0165-1781(89)90047-4
24. Bertolazi AN, Fagondes SC, Hoff LS, et al. Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Med. Jan 2011;12(1):70-5. doi:10.1016/j.sleep.2010.04.020
25. Lee JH, Cho J. Sleep and Obesity. Sleep Med Clin. Mar 2022;17(1):111-116. doi:10.1016/j.jsmc.2021.10.009
26. Godin O, Henry C, Leboyer M, et al. Sleep quality, chronotype and metabolic syndrome components in bipolar disorders during the remission period: Results from the FACE-BD cohort. Chronobiol Int. 2017;34(8):1114-1124. doi:10.1080/07420528.2017.1332071
27. Kiełbasa G, Stolarz-Skrzypek K, Pawlik A, et al. Assessment of sleep disorders among patients with hypertension and coexisting metabolic syndrome. Advances in Medical Sciences. 2016/09/01/ 2016;61(2):261-268. doi:
28. Wang Y, Jiang T, Wang X, et al. Association between Insomnia and Metabolic Syndrome in a Chinese Han Population: A Cross-sectional Study. Scientific reports. 2017;7(1):10893-10893. doi:10.1038/s41598-017-11431-6
29. Zohal M, Ghorbani A, Esmailzadehha N, Ziaee A, Mohammadi Z. Association of sleep quality components and wake time with metabolic syndrome: The Qazvin Metabolic Diseases Study (QMDS), Iran. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017/11/01/ 2017;11:S377-S380. doi:
30. Lee J, Choi YS, Jeong YJ, et al. Poor-quality sleep is associated with metabolic syndrome in Korean adults. Tohoku J Exp Med. Dec 2013;231(4):281-91. doi:10.1620/tjem.231.281
31. Chen L-J, Lai Y-J, Sun W-J, Fox KR, Chu D, Ku P-W. Associations of exercise, sedentary time and insomnia with metabolic syndrome in Taiwanese older adults: A 1-year follow-up study. Endocrine Research. 2015/10/02 2015;40(4):220-226. doi:10.3109/07435800.2015.1020547
32. Tsou M-T. The Impact of Insomnia Symptoms on Risk Factors of Metabolic Syndrome among the Urban Elderly in Northern Taiwan. OALib. 01/01 2015;02:1-10. doi:10.4236/oalib.1102013
33. Deng HB, Tam T, Zee BC, et al. Short Sleep Duration Increases Metabolic Impact in Healthy Adults: A Population-Based Cohort Study. Sleep. Oct 1 2017;40(10)doi:10.1093/sleep/zsx130
34. Yoo H, Franke WD. Sleep habits, mental health, and the metabolic syndrome in law enforcement officers. J Occup Environ Med. Jan 2013;55(1):99-103. doi:10.1097/JOM.0b013e31826e294c
35. Jennings JR, Muldoon MF, Hall M, Buysse DJ, Manuck SB. Self-reported Sleep Quality is Associated With the Metabolic Syndrome. Sleep. 2007;30(2):219-223. doi:10.1093/sleep/30.2.219