Association between circulating antioxidants and sleep disorders: Comprehensive results from NHANES 2017–2018

Abstract

Background: Oxidative stress plays an important role in the occurrence and pathological process of numerous human diseases. Bidirectional relationship was found between sleep disorders and oxidative stress. However, the population-scale association between circulating antioxidant levels and the risk of sleep disorders has yet to be determined. Methods: We used the dataset from the National Health and Nutrition Examination Survey 2017–2018 data release cycle and included 3,062 adult participants aged 20 years and above. The circulating antioxidants levels were measured by serum concentrations, and the sleep status was assessed through self-reported sleep disorder questionnaire tests. We investigated the association and exposure-response relationship between 12 main circulating antioxidants and sleep disorders through generalized additive model (GAM), multiple linear regression, binary logistic regression, and restricted cubic spline (RCS) regression models. Multiple sensitivity analyses were conducted to validate the results of our study. Results: Significantly lower serum concentrations of ten antioxidants were observed in the trouble sleeping group compared to the control group. After adjusting for all covariates, binary logistic regression models indicated that six circulating antioxidants including alpha-carotene, alpha-cryptoxanthin, trans-beta-carotene, beta-cryptoxanthin, lutein and zeaxanthin, and vitamin C, were significant association with the risk of sleep disorders with the odds ratios were corresponding 0.881 (95%CI:0.801–0.968), 0.737 (95%CI:0.624–0.871), 0.872 (95%CI:0.786–0.967), 0.845 (95%CI:0.75–0.952), 0.719 (95%CI:0.613–0.843), and 0.829 (95%CI:0.737–0.931) after adjusting for all covariates. GAM and multiple linear regression revealed similar associations while the RCS regression models further confirmed their significant negatively exposure-response relationship. Conclusions: In conclusion, circulating carotenoids and vitamin C levels were negatively correlated with the risk of sleep disorders. Higher circulating antioxidants levels were significantly associated with a lower risk of sleep disorders. The potential health risk of low circulating antioxidants levels was higher in female population than in male population.