The associations of bedtime, sleep duration, inflammation, and insulin resistance among adults in the United States: Cross-sectional NHANES 2021-2023

Authors

• Shuo Feng, Texas A&M UniversityFollow
• Qiyue Zhang, Texas A&M UniversityFollow
• Ping Ma, Texas A&M UniversityFollow

Abstract

Using national data, this study aims to explore the direct associations of bedtime, sleep duration, inflammation, and insulin resistance, as well as the mediation effect of inflammation on the relationship between sleep and insulin resistance among adults in the U.S. Adults aged 18 and older from the National Health and Nutrition Examination Survey (NHANES) 2021–2023 were included. The analytic sample consisted of 2,843 participants. Structural Equation Modeling and the Monte Carlo method were employed for data analysis. Sleep duration and bedtime were self-reported. Inflammation was assessed using C-reactive protein (CRP) and insulin resistance using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) formula. The structural Equation Model (SEM) path model and the Monte Carlo method were used for testing the direct and indirect (mediation) effects. The results revealed that long sleep duration was associated with a higher HOMA-IR level, compared to recommended sleep duration (β=2.40, p

Creative Commons License

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Recommended Citation

Feng, Shuo; Zhang, Qiyue; and Ma, Ping (2026) "The associations of bedtime, sleep duration, inflammation, and insulin resistance among adults in the United States: Cross-sectional NHANES 2021-2023," Health Behavior Research: Vol. 9: No. 1.