Weekend catch-up sleep and frailty in US adults: a cross-sectional study from NHANES 2017–2020

Abstract Background Frailty is an age-related condition characterized by vulnerability to adverse health outcomes. Adequate sleep may reduce frailty risk, many individuals rely on weekend catch-up sleep (WCS) to offset weekday deficits. However, the relationship between WCS and frailty remains poorl...

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Main Authors: Huan Yao, Hu Wang, Tao Li, Xia Feng, Dan Liu, Yingyue Zhang, Minling Li, Gui Xiao
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22793-2
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author Huan Yao
Hu Wang
Tao Li
Xia Feng
Dan Liu
Yingyue Zhang
Minling Li
Gui Xiao
author_facet Huan Yao
Hu Wang
Tao Li
Xia Feng
Dan Liu
Yingyue Zhang
Minling Li
Gui Xiao
author_sort Huan Yao
collection DOAJ
description Abstract Background Frailty is an age-related condition characterized by vulnerability to adverse health outcomes. Adequate sleep may reduce frailty risk, many individuals rely on weekend catch-up sleep (WCS) to offset weekday deficits. However, the relationship between WCS and frailty remains poorly understood. This study aims to clarify the association between WCS and frailty. Methods We conducted secondary data analyses using data from 7714 adult participants in the National Health and Nutrition Examination Survey (NHANES 2017–2020). Sleep duration was assessed through self-reported questions, while frailty was evaluated using the frailty index. WCS duration was then computed as the difference between weekend and weekday sleep durations, with WCS defined as WCS duration ≤ 0 h, 0–2 h, or ≥ 2 h. A frailty index of 0.25 or greater is considered frailty. Multivariate logistic regression analyses were conducted to explore the association between WCS and frailty. Results In fully adjusted models, participants with 0–2 h of WCS had significantly lower odds of frailty (OR 0.709; 95% CI, 0.518–0.969; P = 0.035) compared to those with no WCS (≤ 0 h). However, the association was not significant for those with ≥ 2 h of WCS (OR 0.812; 95% CI, 0.550–1.200; P = 0.248). Subgroup analyses indicated no significant interaction across subgroups (P for interaction > 0.05). Limitations The cross-sectional design limits our ability to infer causality, and the reliance on self-reported sleep data may introduce measurement bias. Additionally, the frailty index, while validated, may not capture all dimensions of frailty. Future longitudinal studies with objective sleep measurements are needed to confirm these findings. Conclusions Our findings suggest that moderate WCS (0–2 h) may be associated with a lower prevalence of frailty, although the relationship is not linear and requires further investigation. These findings contribute to the emerging evidence base linking sleep patterns with frailty risk, warranting further prospective investigation.
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spelling doaj-art-c49c49e86c2849f89ea2b6d1a73ffb9c2025-08-20T03:15:10ZengBMCBMC Public Health1471-24582025-04-0125111310.1186/s12889-025-22793-2Weekend catch-up sleep and frailty in US adults: a cross-sectional study from NHANES 2017–2020Huan Yao0Hu Wang1Tao Li2Xia Feng3Dan Liu4Yingyue Zhang5Minling Li6Gui Xiao7Department of Nursing, Guizhou Provincial People’s HospitalEmergency Center, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Emergency, Guizhou Provincial People’s HospitalDepartment of Sleep Medicine, the Second People’s Hospital of Guizhou ProvinceDepartment of Emergency, Guizhou Provincial People’s HospitalDepartment of Emergency, Guizhou Provincial People’s HospitalEmergency Center, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Nursing, Jiangxi University of Chinese MedicineAbstract Background Frailty is an age-related condition characterized by vulnerability to adverse health outcomes. Adequate sleep may reduce frailty risk, many individuals rely on weekend catch-up sleep (WCS) to offset weekday deficits. However, the relationship between WCS and frailty remains poorly understood. This study aims to clarify the association between WCS and frailty. Methods We conducted secondary data analyses using data from 7714 adult participants in the National Health and Nutrition Examination Survey (NHANES 2017–2020). Sleep duration was assessed through self-reported questions, while frailty was evaluated using the frailty index. WCS duration was then computed as the difference between weekend and weekday sleep durations, with WCS defined as WCS duration ≤ 0 h, 0–2 h, or ≥ 2 h. A frailty index of 0.25 or greater is considered frailty. Multivariate logistic regression analyses were conducted to explore the association between WCS and frailty. Results In fully adjusted models, participants with 0–2 h of WCS had significantly lower odds of frailty (OR 0.709; 95% CI, 0.518–0.969; P = 0.035) compared to those with no WCS (≤ 0 h). However, the association was not significant for those with ≥ 2 h of WCS (OR 0.812; 95% CI, 0.550–1.200; P = 0.248). Subgroup analyses indicated no significant interaction across subgroups (P for interaction > 0.05). Limitations The cross-sectional design limits our ability to infer causality, and the reliance on self-reported sleep data may introduce measurement bias. Additionally, the frailty index, while validated, may not capture all dimensions of frailty. Future longitudinal studies with objective sleep measurements are needed to confirm these findings. Conclusions Our findings suggest that moderate WCS (0–2 h) may be associated with a lower prevalence of frailty, although the relationship is not linear and requires further investigation. These findings contribute to the emerging evidence base linking sleep patterns with frailty risk, warranting further prospective investigation.https://doi.org/10.1186/s12889-025-22793-2FrailtyWeekend catch-up sleepUS adultsCross-sectional study
spellingShingle Huan Yao
Hu Wang
Tao Li
Xia Feng
Dan Liu
Yingyue Zhang
Minling Li
Gui Xiao
Weekend catch-up sleep and frailty in US adults: a cross-sectional study from NHANES 2017–2020
BMC Public Health
Frailty
Weekend catch-up sleep
US adults
Cross-sectional study
title Weekend catch-up sleep and frailty in US adults: a cross-sectional study from NHANES 2017–2020
title_full Weekend catch-up sleep and frailty in US adults: a cross-sectional study from NHANES 2017–2020
title_fullStr Weekend catch-up sleep and frailty in US adults: a cross-sectional study from NHANES 2017–2020
title_full_unstemmed Weekend catch-up sleep and frailty in US adults: a cross-sectional study from NHANES 2017–2020
title_short Weekend catch-up sleep and frailty in US adults: a cross-sectional study from NHANES 2017–2020
title_sort weekend catch up sleep and frailty in us adults a cross sectional study from nhanes 2017 2020
topic Frailty
Weekend catch-up sleep
US adults
Cross-sectional study
url https://doi.org/10.1186/s12889-025-22793-2
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