Sleep Duration, but Not Screen-Based Sedentary Time, Predicts Glycemic Control: A Weighted NHANES 2017–2020 Analysis

Background Both inadequate sleep and a sedentary lifestyle are associated with metabolic disorders. However, the effects of prolonged periods of screen-based sedentary behavior on long-term glycemic control in adults have not been fully studied. This study examined the independent associations of sleep duration and screen-based sedentary time with glycated hemoglobin (HbA1c) levels in U.S. adults. Methods We analyzed data from the NHANES 2017–March 2020 cycle ( N  = 8,242). A multiple linear regression analysis examined relationships between sleep length, screen-based sedentary time, and hemoglobin A1c (HbA1c) while controlling for the effects of age and body mass index (BMI). Results The relationship between sleep duration and HbA1c was statistically significant, with more sleep correlating with lower HbA1c levels (𝛃 = -0.023, p < 0.001). Specifically, for every hour of sleep reported by participants, HbA1c decreased by 0.023 percentage points per additional hour of sleep. Conversely, there was no relationship between sedentary screen-based time and HbA1c levels (p = .998). Age and body mass index (BMI) were also statistically significantly related to HbA1c levels. Conclusion These findings suggest that glycemic control is more strongly associated with sleep duration and adiposity than with screen-based sedentary behavior. Therefore, it appears that the metabolic risk factors associated with digital sedentary time are primarily attributed to sleep disruption. Public health initiatives should prioritize sleep hygiene as an important strategy for improving metabolic health.