Exploring sociodemographic moderators of the association between sleep duration and self-rated health

Objective This study examined the association of sleep duration with self-rated health (SRH) and if age, sex, and race/ethnicity modifies this association. Methods This was a cross-sectional analysis of 396,455 adults who were aged >= 18 years in the 2020 Behavioral Risk Factor Surveillance System. Sleep duration was categorized into three: short (< 7 h), normal (7-9 h; reference), and long (> 9 h). SRH was dichotomized into suboptimal (fair/poor; reference) and optimal (excellent/very good/good). Logistic regression models were employed to investigate the association and assess interactions of age, sex, and race/ethnicity with sleep duration. Results Short (adjusted odds ratio: 0.70 [95% confidence interval 0.66-0.74]) and long (0.65 [0.58-0.73]) sleep duration was associated with decreased odds of optimal SRH. There was a significant interaction between age and sleep duration (p = 0.029). The association between short sleep duration and SRH was strongest in the youngest age (18-24; 0.59 [0.47-0.74]), while 35-44 (0.57 [0.39-0.82] had the strongest association for long sleep duration with SRH. No significant interactions were found for sex (p = 0.314) or race/ethnicity (p = 0.930). Conclusion Short and long sleep duration are associated with decreased odds of optimal SRH among US adults. Prioritizing sleep hygiene across all ages may improve SRH.