# Poor sleep health is associated with worse cardiometabolic risk among rural and urban schooled Nigerian adolescents

## TL;DR

Poor sleep health in Nigerian adolescents is linked to higher cardiometabolic risk, with urban teens facing worse outcomes.

## Contribution

This study provides new evidence on sleep health and cardiometabolic risk in Sub-Saharan African adolescents.

## Key findings

- Poorer sleep quality and duration were associated with higher cardiometabolic risk scores and BMI in adolescents.
- Urban adolescents showed worse sleep health and higher cardiometabolic risk compared to rural peers.
- Risk of sleep apnea was linked to increased cardiometabolic risk and higher blood pressure.

## Abstract

There is limited evidence on the association between sleep health and cardio-metabolic risk (CMR) in Sub-Saharan African adolescents. Using a cross-sectional design, we assessed the association between sleep health and CMR, including 900 adolescents aged 13–19, attending six rural and six urban schools, in Osun State, Nigeria. Sleep health variables included sleep quality and duration (Pittsburgh Sleep Quality Index), risk of sleep apnea (Teen STOPBANG), and daytime sleepiness (Epworth Sleepiness Scale for Children and Adolescents). A continuous CMR-score was calculated using z-scores of mean arterial pressure (MAP), body mass index (BMI), waist circumference (WC), and random blood glucose. We analysed the association between sleep health, place of residence, and CMR using generalized linear models. Urban adolescents presented worse sleep health indicators and higher BMI, WC, and CMR-score (p < 0.05). Overall, poorer sleep quality was associated with higher CMR-score (β = 0.02), BMI z-score (β = 0.04), and WC z-score (β = 0.03) (p < 0.05), and lower sleep duration with higher CMR-score (β = 0.04), BMI z-score (β = 0.11), and WC z-score (β = 0.07) (p < 0.05). Risk of sleep apnea was associated with higher CMR-score (β = 0.08), MAP z-score (β = 0.17), and WC z-score (β = 0.14) (p < 0.05). Improving the sleep health of adolescents may prevent cardiometabolic diseases later in life.

The online version contains supplementary material available at 10.1038/s41598-025-25659-0.