This study revealed a linear association between HDL-related inflammatory biomarkers and sleep disorders, with sex and marital status modifying the associations of all 4 indices with sleep disorders, and these biomarkers also associated with sleep duration.
Higher levels of all four HDL-related inflammatory biomarkers (MHR, NHR, LHR, PHR) were positively associated with prevalence of sleep disorders in fully adjusted models.
The relationships between the inflammatory biomarkers and the likelihood of sleep disorders were linear rather than nonlinear.
Sex and marital status significantly modified the associations between all four indices and sleep disorders.
Both short and long sleep duration were associated with elevated NHR compared with the recommended sleep duration.
The study used a large, nationally sourced cross-sectional sample and tested robustness with sensitivity analyses.
This study used survey data from over 23,000 U.S. adults (NHANES, 2005-2014) to examine whether markers that combine inflammation-related blood cells with HDL ("good") cholesterol are linked to sleep disorders. The four markers compared HDL levels with counts of monocytes, neutrophils, lymphocytes, or platelets. Higher values of all four were associated with greater odds of having a sleep disorder, even after accounting for other factors. The strongest link was for the monocyte-to-HDL ratio, with about 33% higher odds. The relationship appeared to be linear, meaning the odds of a sleep disorder rose steadily as the markers increased rather than jumping at a threshold. The associations differed by sex and marital status. People who slept less than 7 hours or more than 9 hours per day also tended to have higher neutrophil-to-HDL ratios than those sleeping 7-9 hours. This research suggests that inflammation combined with lower HDL may be tied to sleep problems. However, because the study is cross-sectional, it captures a single snapshot and cannot show whether inflammation contributes to sleep disorders, sleep disorders increase inflammation, or both. These blood-based ratios are routinely measured, so they may be useful in future research, but further studies are needed to confirm the findings.
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Upload Your LabsGan L, Cai Y, Shi X, Feng S, Wang T, You Z, et al.. (2026). HDL-related inflammatory biomarkers are associated with sleep disorders: Evidence from a cross-sectional NHANES study.. Advances in clinical and experimental medicine : official organ Wroclaw Medical University. https://doi.org/10.17219/acem/214708