title: Sleep complaints and metabolic syndrome in an elderly population: the Three-City Study.
abstract: OBJECTIVE
  To assess whether sleep complaints (rather than clinically defined sleep disturbances) were associated with the metabolic syndrome (MetS) and each of its components in an elderly population.
  
  
  METHODS
  Cross-sectional analyses of data from the French Three City Study, a large multicenter cohort of elderly community-dwellers.
  
  
  METHODS
  6,354 participants (56.4% women, median age 73; range: 65-97 years).
  
  
  METHODS
  Frequency of insomnia complaints (difficulty in initiating sleep, difficulty in maintaining sleep [DMS], and early morning awakening) and excessive daytime sleepiness (EDS) were self-reported. MetS was assessed using National Cholesterol Education program Adult Treatment Panel III criteria.
  
  
  RESULTS
  A total of 977 participants had MetS. After adjustment for a large range of potential confounders, we report an association between the number of insomnia complaints and MetS. Among insomnia complaints only DMS was consistently associated with MetS (OR: 1.23, 95% CI: 1.06 to 1.43). Our results showed that EDS independently increased the risk of MetS (OR: 1.46, 95% CI: 1.18 to 1.81 for "frequently"; OR: 1.99, 95% CI: 1.49 to 1.67 for "often"). The EDS-MetS association was independent of past-history of cardiovascular disease, insomnia complaints, and obesity and loud snoring.
  
  
  CONCLUSIONS
  We report significant independent associations between frequent sleep complaints (EDS and to a lesser extent DMS) and MetS in the elderly with potential implications in terms of management and cardiovascular prevention in general geriatric practice. Prospective studies are required to clarify the direction of the association between sleep complaints and MetS.
authors.affiliation: INSERM U1061, Université Montpellier, Montpellier, France; INSERM U710, Montpellier, France; EPHE, Paris, France; INSERM U1198, Montpellier, France; Department of Epidemiology and Public Health, University College London, United Kingdom; INSERM U710, Montpellier, France; EPHE, Paris, France. Electronic address: tasnime.akbaraly@inserm.fr.
authors.forename: Tasnime N
authors.initials: TN
authors.lastname: Akbaraly
authors.affiliation: INSERM U1061, Université Montpellier, Montpellier, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaussent
authors.affiliation: INSERM U1061, Université Montpellier, Montpellier, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Besset
authors.affiliation: INSERM U708-Neuroepidemiology, Université Bordeaux-Segalen, Bordeaux, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Bertrand
authors.affiliation: Université Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Barberger-Gateau
authors.affiliation: INSERM U1061, Université Montpellier, Montpellier, France; Faculty of Medicine, Imperial College, London, United Kingdom.
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.affiliation: Department of Epidemiology and Public Health, University College London, United Kingdom.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Ferrie
authors.affiliation: Department of Epidemiology and Public Health, University College London, United Kingdom.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimaki
authors.affiliation: INSERM U1061, Université Montpellier, Montpellier, France; CHU Montpellier, Service de Neurologie, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac, Montpellier, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Dauvilliers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D057566:Self Report; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*
keywords: Metabolic syndrome, sleep complaints, elderly, observational study