Association between allostatic load and trouble sleeping in U.S. adults

Shanshan Yang; Yujie Ma; Hang Fu; Chengzeng Wang; Yafeng Zhang

doi:10.1016/j.jpsychores.2025.112206

Association between allostatic load and trouble sleeping in U.S. adults

J Psychosom Res. 2025 Jun 27:196:112206. doi: 10.1016/j.jpsychores.2025.112206. Online ahead of print.

Authors

Shanshan Yang¹, Yujie Ma², Hang Fu¹, Chengzeng Wang¹, Yafeng Zhang³

Affiliations

¹ The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Institute for Hospital Management of Henan Province, Zhengzhou, China; Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China.
² The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Institute for Hospital Management of Henan Province, Zhengzhou, China.
³ The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Institute for Hospital Management of Henan Province, Zhengzhou, China; Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China. Electronic address: hydzhangyafeng@163.com.

PMID: 40651326
DOI: 10.1016/j.jpsychores.2025.112206

Abstract

Objective: This study examined the association between allostatic load and trouble sleeping and assessed whether this relationship varies based on allostatic load score (ALS) criteria.

Methods: This cross-sectional survey utilized nationally representative data from the National Health and Nutrition Examination Survey (NHANES). ALS was derived using empirical and clinical criteria based on eight biomarkers reflecting cardiovascular, metabolic, and immune function. Weighted multivariate logistic regression was employed to analyze the association between ALS and trouble sleeping, with subgroup analyses conducted to assess gender-specific differences.

Results: Of 5331 participants included in this study, 1485 (29 %) reported trouble sleeping. In multivariate-adjusted logistic regression, higher ALS was associated with increased odds of trouble sleeping (empirical ALS: OR 1.13 [95 % CI 1.07-1.18]; clinical ALS: OR 1.08 [95 % CI 1.04-1.13]). Subgroup analyses confirmed the consistency of this association across genders.

Conclusion: This study provides robust evidence of a significant association between ALS and trouble sleeping, supported by observed OR of 1.13 (empirical) and 1.08 (clinical). The consistency of findings across both empirical and clinical ALS underscores the potential role of physiological dysregulation in sleep health, highlighting the need for integrated approaches to stress and sleep management.

Keywords: Allostatic load; NHANES; Trouble sleeping.