Sleep duration Ratio, a novel parameter associated with a reduced risks of coronary artery disease and myocardial infarction: findings from NHANES 2017–2023

Cardiovascular disease (CVD) is a leading cause of death worldwide. Weekend sleep recovery (WSR), the practice of extending sleep on weekends to compensate for weekday sleep loss, may influence cardiovascular health. This study examines its association with coronary artery disease (CAD) and myocardial infarction (MI) using data from the National Health and Nutrition Examination Survey (NHANES). A cross-sectional study of 14,335 NHANES participants analysed self-reported weekday and weekend sleep durations. The weekend-to-weekday sleep duration ratio (SDR) was calculated, classifying participants as WSR (SDR > 1) or non-WSR (SDR ≤ 1). Multivariate logistic regression models, adjusted for demographics and comorbidities, assessed the association between WSR and CAD/MI risk. Participants had a mean age of 43.9 ± 23.4 years, 52.5% were female, 4.83% had CAD, and 4.46% had MI. The mean weekday and weekend sleep durations were 7.7 ± 1.7 and 8.3 ± 1.8 h, respectively, with 64.8% having WSR. WSR was associated with a reduced risk of CAD and MI (OR = 0.79, 95% CI: 0.67–0.93, p = 0.005), particularly among those with 5–6 h of weekday sleep, older adults, White individuals, and those with diabetes or hypertension. The protective effect was also observed in smokers and individuals with class I and III obesity, but was not significant in Black individuals, non-smokers, or those without obesity. WSR is associated with lower CAD and MI risks, particularly in those with intermediate weekday sleep and specific subgroups. However, its impact varies across populations, warranting further research. Both insufficient and excessive sleep are linked to increased CVD risks.Weekend sleep compensation has been suggested as a potential protective factor for cardiovascular health, though its effects remain underexplored. Both insufficient and excessive sleep are linked to increased CVD risks. Weekend sleep compensation has been suggested as a potential protective factor for cardiovascular health, though its effects remain underexplored. Weekend Sleep Recovery (WSR), defined as the Weekend-to-Weekday Sleep Duration Ratio (SDR) > 1, is introduced as a novel parameter for assessing weekend compensation.WSR is associated with a significant reduction in the risk of coronary artery disease (CAD) and/or myocardial infarction (MI), especially in those with some degree of shorter weekday sleep durations.Protective effects were seen in certain subgroups, including White individuals, smokers, diabetics, hypertensives, and individuals with Class I and III obesity. Weekend Sleep Recovery (WSR), defined as the Weekend-to-Weekday Sleep Duration Ratio (SDR) > 1, is introduced as a novel parameter for assessing weekend compensation. WSR is associated with a significant reduction in the risk of coronary artery disease (CAD) and/or myocardial infarction (MI), especially in those with some degree of shorter weekday sleep durations. Protective effects were seen in certain subgroups, including White individuals, smokers, diabetics, hypertensives, and individuals with Class I and III obesity. Targeted Interventions: Tailored approaches can address high-risk groups, including individuals with obesity, hypertension, or short weekday sleep durations, to reduce cardiovascular risks effectively. As WSR may help reduce cardiovascular risks, particularly in individuals with intermediate weekday sleep durations and those with comorbid conditions.Public Health Policy: These findings can inform sleep-related guidelines and cardiovascular disease prevention strategies, promoting WSR as a potential intervention.Awareness and Education: Raising awareness about the importance of sleep recovery and its benefits can empower individuals to prioritise sleep as part of a healthy lifestyle.Further research: The effectiveness of WSR varies across populations; no significant effects were observed in Black individuals, non-smokers, or non-obese groups. Targeted Interventions: Tailored approaches can address high-risk groups, including individuals with obesity, hypertension, or short weekday sleep durations, to reduce cardiovascular risks effectively. As WSR may help reduce cardiovascular risks, particularly in individuals with intermediate weekday sleep durations and those with comorbid conditions. Public Health Policy: These findings can inform sleep-related guidelines and cardiovascular disease prevention strategies, promoting WSR as a potential intervention. Awareness and Education: Raising awareness about the importance of sleep recovery and its benefits can empower individuals to prioritise sleep as part of a healthy lifestyle. Further research: The effectiveness of WSR varies across populations; no significant effects were observed in Black individuals, non-smokers, or non-obese groups.