Objective:

To investigate the association between metabolic markers and sleep disorders under various environmental and adaptive conditions by comparing lowland residents with high-altitude populations.

Approach:

• Participants: Data from 5,220 participants were analyzed after propensity score matching.
• Methods: Multivariable logistic regression, restricted cubic splines, and interaction analyses were employed to examine associations between metabolic indices and sleep disturbance, adjusted for sociodemographic and lifestyle factors.

Key Findings:

• Sleep disturbance prevalence: lowlanders 14.9%, Plateau population 30.6% (migrants 35.0%, Tibetans 27.1%).
• Plain-dwelling populations showed significant positive associations with all metabolic indices assessed.
• The Plateau population showed significant positive associations with TyG and TyG-WHtR, and negative correlations with potassium.
• Tibetan highlanders exhibited associations only with TyG-related metabolic indicators.
• Among high-altitude migrants, depressive symptoms were associated with a stronger link between TyG-WHtR and sleep disorders.

Interpretation:

Sleep disorders demonstrate heterogeneity across populations, influenced by high-altitude environments and genetic backgrounds.

Limitations:

• The study is cross-sectional, limiting causal inferences.
• Potential confounding factors may not have been fully accounted for.

Conclusion:

High-altitude environments and genetic backgrounds are associated with sleep disorders and modify the effect of established risk factors.

Sources:

• Clinical trial registration