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Volume 15 No. 01
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Accepted Papers

Scientific Investigations

Short Sleep Duration Is Associated With Increased Serum Homocysteine: Insights From a National Survey

Tien-Yu Chen, MD1,2,3,4; John W. Winkelman, MD, PhD5; Wei-Chung Mao, MD3,6; Chin-Bin Yeh, MD, PhD1,7; San-Yuan Huang, MD, PhD1,7; Tung-Wei Kao, MD2,8; Cheryl C.H. Yang, PhD3,4; Terry B.J. Kuo, MD, PhD3,4,9; Wei-Liang Chen, MD, PhD2,7,8
1Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan; 2School of Medicine, National Defense Medical Center, Taipei, Taiwan; 3Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; 4Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; 5Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; 6Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan; 7Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan; 8Division of Family Medicine and Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan; 9Graduate Institute of Biomedical informatics, Taipei Medical University, Taipei, Taiwan

Study Objectives:

Both short sleep duration and increased serum homocysteine levels are associated with cardiovascular events. However, research on the relationship between sleep duration and serum homocysteine levels is sparse. The aim of this study is to examine the association between sleep duration and serum homocysteine levels from a national database.


In total, 4,480 eligible participants older than 20 years who had serum homocysteine data and reported sleep duration were enrolled from the US National Health and Nutrition Examination Survey of 2005 to 2006. The association between sleep duration and serum homocysteine levels was analyzed using multivariate regression models for covariate adjustment.


Serum homocysteine level was lowest in individuals with a sleep duration of 7 hours and increased in those with both shorter and longer self-reported total sleep time (groups were categorized into ≤ 5 hours, 6 hours, 7 hours, 8 hours, and ≥ 9 hours). After adjustment for covariates, those in the group sleeping ≤ 5 hours had significantly higher serum homocysteine levels than the reference group (sleep duration of 7 hours). In subgroup analyses by sex, body mass index (BMI), and ethnicity, the association between short sleep duration (≤ 5 hours) and higher serum homocysteine levels persisted in women, individuals with obesity (BMI ≥ 30 kg/m2), and non-Hispanic whites.


This study highlighted that short sleep duration was associated with higher serum homocysteine levels in women, individuals with obesity (BMI ≥ 30 kg/m2), and non-Hispanic whites; this finding might suggest increased vulnerability to cardiovascular risk or other atherothrombotic events in these groups in the context of short sleep.


Chen TY, Winkelman JW, Mao WC, Yeh CB, Huang SY, Kao TW, Yang CC, Kuo TB, Chen WL. Short sleep duration is associated with increased serum homocysteine: insights from a national survey. J Clin Sleep Med. 2019;15(1):139–148.

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