title: Interactive effects of sleep duration and morning/evening preference on cardiovascular risk factors.
abstract: Sleep duration and morningness/eveningness (circadian preference) have separately been associated with cardiovascular risk factors (i.e. tobacco use, physical inactivity). Interactive effects are plausible, resulting from combinations of sleep homeostatic and circadian influences. These have not been examined in a population sample.
  
  
  
  Multivariable regression models were used to test the associations between combinations of sleep duration (short [≤6 h], adequate [7-8 h], long [≥9 h]) and morning/evening preference (morning, somewhat morning, somewhat evening, evening) with the cardiovascular risk factors of tobacco use, physical inactivity, high sedentary behaviour, obesity/overweight and eating fewer than 5 daily servings of fruit and vegetables, in a cross-sectional sample of 439 933 adults enrolled in the United Kingdom Biobank project.
  
  
  
  Participants were 56% female, 95% white and mean age was 56.5 (SD = 8.1) years. Compared with adequate sleep with morning preference (referent group), long sleep with evening preference had a relative odds of 3.23 for tobacco use, a 2.02-fold relative odds of not meeting physical activity recommendations, a 2.19-fold relative odds of high screen-based sedentary behaviour, a 1.47-fold relative odds of being obese/overweight and a 1.62-fold relative odds of <5 fruit and vegetable daily servings. Adequate sleep with either morning or somewhat morning preference was associated with a lower prevalence and odds for all cardiovascular risk behaviours except fruit and vegetable intake.
  
  
  
  Long sleepers with evening preference may be a sleep phenotype at high cardiovascular risk. Further work is needed to examine these relationships longitudinally and to assess the effects of chronotherapeutic interventions on cardiovascular risk behaviours.
authors.affiliation: Department of Behavioral Health and Nutrition, University of Delaware, Bob Carpenter Sports Building, Newark, DE 19716, USA.
authors.forename: Freda
authors.initials: F
authors.lastname: Patterson
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA.|Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Susan Kohl
authors.initials: SK
authors.lastname: Malone
authors.affiliation: Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ 85724-5002, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grandner
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Lozano
authors.affiliation: Department of Behavioral Health and Nutrition, University of Delaware, Bob Carpenter Sports Building, Newark, DE 19716, USA.
authors.forename: Mackenzie
authors.initials: M
authors.lastname: Perkett
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hanlon
mesh_terms: D002318:Cardiovascular Diseases / Q000523:psychology*; D002940:Circadian Rhythm; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data; D015444:Exercise / Q000523:psychology; D005260:Female; D000073599:Health Risk Behaviors; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior; D012890:Sleep; D013997:Time Factors; D064424:Tobacco Use / Q000453:epidemiology / Q000523:psychology; D006113:United Kingdom