Relationship of sleep quality to body fat distribution and cardiovascular risk in young men

Introduction. In young men, there is a close relationship between sleep quality (SQ), fat tissue (FT) distribution, and cardiovascular diseases.
Aim. To study sleep quality (SQ) characteristics in young men depending on abdominal obesity (AO) and fat tissue distribution (FTD), and to determine their associations with body composition parameters and cardiovascular risk (CVR) assessment scales.
Materials and methods. A cross-sectional comparative study based on anthropometry and bioimpedance analysis enrolled 150 men aged 20–45 in three groups of 50 each: 1 – without AO, 2 – with AO and predominantly subcutaneous type of FTD, 3 – with AO and predominantly visceral type of FTD. Sleep assessment was performed using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, and overnight computer pulse oximetry monitoring. The following scales were used to assess CVR: SCORE2, Framingham 2008, PREVENT, QRISK3, Framingham-30, Mayo Clinic Heart Disease Risk Calculator.
Results. Subjective SQ parameters did not differ between the groups (p > 0.05). The desaturation index (DI) in Group 1 was significantly lower than in Group 3 (3.7 [2.3; 4.8] and 6.2 [4.3; 11.5] episodes per hour, p1-3 = 0.001). Possible sleep apnea was more characteristic of Group 3 (44% and 18%, p1-3 = 0.015). Mean and minimum nocturnal oxygen saturation inversely correlated with absolute CVR (rs = -0.220 to -0.187, p < 0.001–0.026). DI and time with oxygen saturation ≤89% (T90%) positively correlated with CVR levels across all studied scales except SCORE2 (rs = 0.213–0.338, p < 0.001–0.047). Nighttime sleep duration, PSQI score and T90% correlated with relative CVR (rs = 0.167–0.335, p < 0.001–0.049).
Conclusions. Subjective SQ does not differ between young men with and without AO. Poor nighttime sleep characteristics are associated with the presence of obesity and FTD. Subjective SQ parameters and the objective T90% index correlated with relative CVR scale values, while only objective SQ parameters correlated with absolute CVR scales.

1. Feingold CL, Smiley A. Healthy Sleep Every Day Keeps the Doctor Away. Int J Environ Res Public Health. 2022;19(17):10740. https://doi.org/10.3390/ijerph191710740.

2. Ribeiro LL, Rossi de Almeida V, Martins da Silva D, Rossi de Almeida F. Sleep quality, sedentary behavior and cardiovascular risk in young adults. Brazilian Journal of Natural Sciences. 2023;5(1):E1742023-1. https://doi.org/10.31415/bjns.v5i1.174.

3. Fernström M, Fernberg U, Hurtig-Wennlöf A. The importance of cardiorespiratory fitness and sleep duration in early CVD prevention: BMI, resting heart rate and questions about sleep patterns are suggested in risk assessment of young adults, 18-25 years : The cross-sectional lifestyle, biomarkers and atherosclerosis (LBA) study. BMC Public Health. 2020;20(1):1715. https://doi.org/10.1186/s12889-020-09801-3.

4. Addo PNO, Mundagowa PT, Zhao L, Kanyangarara M, Brown MJ, Liu J. Associations between sleep duration, sleep disturbance and cardiovascular disease biomarkers among adults in the United States. BMC Public Health. 2024;24(1):947. https://doi.org/10.1186/s12889-024-18381-5.

5. Yu Y, Chen Y, Zhang H, Ai S, Zhang J, Benedict C et al. Sleep Duration and Visceral Adipose Tissue: Linear and Nonlinear Mendelian Randomization Analyses. J Clin Endocrinol Metab. 2022;107(11):2992–2999. https://doi.org/10.1210/clinem/dgac551.

6. Tsygankova OV, Badin AR, Bondareva ZG, Lozhkina NG, Platonov DY. Associations of sex hormones with components of insulin-glucose homeostasis. Obesity and Metabolism. 2018;15(2):3–10. (In Russ.) https://doi.org/10.14341/omet9482.

7. Rodrigues GD, Fiorelli EM, Furlan L, Montano N, Tobaldini E. Obesity and sleep disturbances: The “chicken or the egg” question. Eur J Intern Med. 2021;92:11–16. https://doi.org/10.1016/j.ejim.2021.04.017.

8. Tao F, Cao Z, Jiang Y, Fan N, Xu F, Yang H et al. Associations of sleep duration and quality with incident cardiovascular disease, cancer, and mortality: a prospective cohort study of 407,500 UK biobank participants. Sleep Med. 2021;81:401–409. https://doi.org/10.1016/j.sleep.2021.03.015.

9. Xue R, Li Q, Geng Y, Wang H, Wang F, Zhang S.Abdominal obesity and risk of CVD: a dose-response meta-analysis of thirty-one prospective studies. Br J Nutr. 2021;126(9):1420–1430. https://doi.org/10.1017/S0007114521000064.

10. Zhernakova YuV, Zheleznova EA, Chazova IE, Oshchepkova EV, Dolgusheva YuA, Yarovaya EB et al. The prevalence of abdominal obesity and the association with socioeconomic status In Regions of the Russian Federation, the results of the epidemiological study ESSE-RF. Terapevticheskii Arkhiv. 2018;90(10):14–22. (In Russ.) https://doi.org/10.26442/terarkh201890104-22.

11. Bochkarev MV, Korostovtseva LS, Filchenko IA, Rotar OP, Sviryaev YuV, Zhernakova YuV et al. Social-demographic aspects of insomnia in the Russian population according to ESSE-RF study. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2018;118(4-2):26–34. (In Russ.) https://doi.org/10.17116/jnevro20181184226.

12. Kasper AM, Langan-Evans C, Hudson JF, Brownlee TE, Harper LD, Naughton RJ et al. Come Back Skinfolds, All Is Forgiven: A Narrative Review of the Efficacy of Common Body Composition Methods in Applied Sports Practice. Nutrients. 2021;13(4):1075. https://doi.org/10.3390/nu13041075.

13. https://irbis.rmapo.ru/UploadFilesUchebPosobiya/uchposobie_insomnii_v_pechaty.pdf.

14. Kobalava ZhD, Konradi AO, Nedogoda SV, Shlyakhto EV, Arutyunov GP, Baranova EI et al. 2024 Clinical practice guidelines for Hypertension in adults. Russian Journal of Cardiology. 2024;29(9):6117. (In Russ.). https://doi.org/10.15829/1560-4071-2024-6117.

15. Suzuki R, Watanabe S, Hirai Y, Akiyama K, Nishide T, Matsushima Y et al. Abdominal wall fat index, estimated by ultrasonography, for assessment of the ratio of visceral fat to subcutaneous fat in the abdomen. Am J Med. 1993;95(3):309–314. https://doi.org/10.1016/0002-9343(93)90284-v.

16. Xue M, Zhang X, Chen K, Zheng F, Wang B, Lin Q et al. Visceral adiposity index, premature mortality, and life expectancy in US adults. Lipids Health Dis. 2025;24(1):139. https://doi.org/10.1186/s12944-025-02560-3.

17. https://elibrary.ru/vfjloj.

18. Esteban-Amarilla C, Martin-Bote S, Jurado-Garcia A, Palomares-Muriana A, Feu-Collado N, Jurado-Gamez B. Usefulness of Home Overnight Pulse Oximetry in Patients with Suspected Sleep-Disordered Breathing. Can Respir J. 2020;2020:1891285. https://doi.org/10.1155/2020/1891285.

19. Huang Y, Wang Y, Huang Y, Zhai M, Zhou Q, Zhao X et al. Prognostic value of sleep apnea and nocturnal hypoxemia in patients with decompensated heart failure. Clin Cardiol. 2020;43(4):329–337. https://doi.org/10.1002/clc.23319.

20. Oldenburg O, Wellmann B, Buchholz A, Bitter T, Fox H, Thiem U et al. Nocturnal hypoxaemia is associated with increased mortality in stable heart failure patients. Eur Heart J. 2016;37(21):1695–1703. https://doi.org/10.1093/eurheartj/ehv624.

21. Veretyuk VV, Tsygankova OV, Ametov AS. Evaluation of a Cardiovascular Risk in Young Men. Doktor.Ru. 2023;22(4):7–17. (In Russ.) https://doi.org/10.31550/1727-2378-2023-22-4-7-17.

22. Veretyuk VV, Tsygankova OV, Timoshchenko OV. Cardiovascular risk assessment and its association with body fat distribution pattern in young men. Meditsinskiy Sovet. 2025;19(6):230–240. (In Russ.) https://doi.org/10.21518/ms2025-057.

23. Rodrigues GD, Fiorelli EM, Furlan L, Montano N, Tobaldini E. Obesity and sleep disturbances: The “chicken or the egg” question. Eur J Intern Med. 2021;92:11–16. https://doi.org/10.1016/j.ejim.2021.04.017.

24. Svetnik V, Snyder ES, Tao P, Roth T, Lines C, Herring WJ. How well can a large number of polysomnography sleep measures predict subjective sleep quality in insomnia patients? Sleep Med. 2020;67:137–146. https://doi.org/10.1016/j.sleep.2019.08.020.

25. Saeed HA, Mohsen AH, Alqayem AT, Hasan SH, Hasan MM, Alzeera HA. Sleep Quality and Its Contributing Factors Among Patients With Obesity: A Cross-Sectional Study. Cureus. 2024;16(11):e74038. https://doi.org/10.7759/cureus.74038.

26. Ahmed Abdallah A, Mohamad Mahfouz E, Sameh Mohammed E, Anwer Emam S, Ahmed Abd-El Rahman T. Sleep quality and its association with body weight among adults: an epidemiological study. Malaysian J Public Health Med. 2021;21(1):327–335. https://doi.org/10.37268/mjphm/vol.20/no.3/art.912.

27. Tsygankova OV, Kalinina EM, Latyntseva LD, Voevoda MI. Successful correction of refractory arterial hypertension and morbid obesity in patient with severe obstructive apnea syndrome. Russian Journal of Cardiology. 2018;(5):74–80. (In Russ.) https://doi.org/10.15829/1560-4071-2018-5-74-80.

28. Covassin N, Singh P, McCrady-Spitzer SK, St Louis EK, Calvin AD, Levine JA, Somers VK. Effects of Experimental Sleep Restriction on Energy Intake, Energy Expenditure, and Visceral Obesity. J Am Coll Cardiol. 2022;79(13):1254–1265. https://doi.org/10.1016/j.jacc.2022.01.038.

29. Deng H, Duan X, Huang J, Zheng M, Lao M, Weng F et al.Association of adiposity with risk of obstructive sleep apnea: a population-based study. BMC Public Health. 2023;23(1):1835. https://doi.org/10.1186/s12889-023-16695-4.

30. Ma B, Li Y, Wang X, Du L, Wang S, Ma H et al. Association Between Abdominal Adipose Tissue Distribution and Obstructive Sleep Apnea in Chinese Obese Patients. Front Endocrinol. 2022;13:847324. https://doi.org/10.3389/fendo.2022.847324.

31. Yeghiazarians Y, Jneid H, Tietjens JR, Redline S, Brown DL, El-Sherif N et al. Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021;144(3):e56–e67. https://doi.org/10.1161/CIR.0000000000000988.

32. Mitra AK, Bhuiyan AR, Jones EA. Association and Risk Factors for Obstructive Sleep Apnea and Cardiovascular Diseases: A Systematic Review. Diseases. 2021;9(4):88. https://doi.org/10.3390/diseases9040088.

33. Alterki A, Abu-Farha M, Al Shawaf E, Al-Mulla F, Abubaker J. Investigating the Relationship between Obstructive Sleep Apnoea, Inflammation and Cardio-Metabolic Diseases. Int J Mol Sci. 2023;24(7):6807. https://doi.org/10.3390/ijms24076807.

34. Albertsen IE, Bille J, Piazza G, Lip GYH, Nielsen PB. Cardiovascular Risk in Young Patients Diagnosed With Obstructive Sleep Apnea. J Am Heart Assoc. 2024;13(8):e033506. https://doi.org/10.1161/JAHA.123.033506.

35. Jin Q, Yang N, Dai J, Zhao Y, Zhang X, Yin J, Yan Y. Association of Sleep Duration With All-Cause and Cardiovascular Mortality: A Prospective Cohort Study. Front Public Health. 2022;10:880276. https://doi.org/10.3389/fpubh.2022.880276.

36. Huang YM, Xia W, Ge YJ, Hou JH, Tan L, Xu W, Tan CC. Sleep duration and risk of cardio-cerebrovascular disease: A dose-response meta-analysis of cohort studies comprising 3.8 million participants. Front Cardiovasc Med. 2022;9:907990. https://doi.org/10.3389/fcvm.2022.907990.