Effect of Sleep Hygiene on Metabolic Syndrome in an Adult Rural Population in India: Protocol for a Cross-Sectional Study.

Abstract

Background: Metabolic syndrome (MetS) refers to a group of conditions including high blood pressure, excess weight, high blood glucose, and abnormal cholesterol and triglyceride levels that together substantially increase the risk of heart disease and diabetes. Poor sleep hygiene is associated with a higher likelihood of type 2 diabetes, while sleep duration can affect the development of various MetS components. Approximately 25% of adults worldwide currently have MetS, and this prevalence is projected to increase to 50% by 2035. However, there is a distinct lack of evidence about the specific impact of sleep hygiene on cardiometabolic health within the rural Indian population. This study will focus on addressing this literature gap by evaluating these risk factor associations by using validated tools to help develop targeted community interventions.

Objective: This study aims to estimate the prevalence of poor sleep quality and cardiometabolic risk factors in a rural Indian population and to determine the association between sleep hygiene and cardiometabolic risk factors.

Methods: This study will be a community-based, cross-sectional, analytical study, and data collection will be carried out by trained personnel using validated tools during house-to-house visits. In this cross-sectional study of 281 rural Indian adults aged ≥40 years, sleep quality will be assessed via the Pittsburgh Sleep Quality Index (a score >5 indicates poor sleep), alongside direct measurements of blood pressure, fasting plasma glucose, BMI (≥25 kg/m² for obesity), waist circumference, and the Madras Diabetes Research Foundation-Indian Diabetes Risk Score for diabetes risk. Data will be collected through a door-to-door approach, with informed consent entered into Google Forms, and quality checked via training and regular reviews. Using R software, analyses will include prevalence estimates with 95% CIs; chi-square or t tests for associations between poor sleep and cardiometabolic risks; and logistic regression (P<.05) adjusted for confounders such as diet, stress, and physical activity.

Results: This study began in January 2025 with conceptualization and ethics approval obtained in June 2025. Data collection commenced in August 2025 following Clinical Trial Registry-India registration, with 53 participants enrolled as of May 5, 2026. Standardized tools (GAD-7, PHQ-9, and GPAQ) were incorporated to assess key confounding variables. Data collection is projected to finish by January 2027, with final analysis and study conclusion expected by March 2027.

Conclusions: The relationship between MetS and sleep hygiene warrants greater attention, particularly as poor sleep habits become increasingly prevalent alongside MetS. This study will deepen the understanding of their connection, paving the way for targeted interventions and prevention strategies.

Trial registration: Clinical Trial Registry-India CTRI/2025/08/092892; https://tinyurl.com/3sak2h9x.

International registered report identifier (irrid): DERR1-10.2196/90117.