{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:46:55Z","timestamp":1791820015236,"version":"4.3.4"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cadmium is a heavy metal that accumulates in the body due to environmental and occupational exposure. The neurotoxicity of cadmium received increasingly attention in recent years. Sleeping is regulated and coordinated by nervous system, however, little is known about the relationship between cadmium and sleep. This study aimed to examine the relationship between blood cadmium concentrations and sleep-related disorders in US adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study used data on blood cadmium and sleep from the 2005\u20132008 and 2015\u20132020 National Health and Nutrition Examination Survey (NHANES). Weighted multiple regression, generalized weighted modeling, and weighted restricted cubic splines (RCS) were utilized to investigate the association between blood cadmium and sleep outcomes (sleep duration, trouble sleeping, symptoms of obstructive sleep apnea (OSA) and daytime sleepiness). Furthermore, subgroup analyses were conducted to investigate any differences in the associations between age, gender, ethnicity, education level, marital status, smoking status, alcohol consumption, diabetes mellitus (DM), cardiovascular disease (CVD) and hypertension groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 19,152 participants, the median blood cadmium concentration was 0.48 (IQR: 0.28, 0.82)\u03bcg\/L. Compared with the lowest reference quartile, participants in the higher quartile had a significantly higher risk of insufficient sleeping (&amp;lt;7\u2009h\/night) in crude model (OR 1.53, 95% CI 1.33\u20131.74), Model 1 (OR 1.57, 95% CI 1.38\u20131.80) and Model 2 (OR 1.45, 95% CI 1.27\u20131.65). In the unadjusted model, individuals in the highest quartile of cadmium level had a significantly increased risk of OSA symptoms of 53% (OR\u2009=\u20091.53, 95% CI: 1.42, 1.65) compared with participants in the bottom quartile, and this risk increased by 35% (OR\u2009=\u20091.35, 95% CI: 1.23, 1.48) after adjusting for all covariates. Individuals in the highest quartile of cadmium level were 76% more likely to have a trouble sleeping than individuals in the lowest quartile in the unadjusted model (OR\u2009=\u20091.76, 95% CI: 1.31, 1.93), whereas in the fully adjusted model, this likelihood was 86% higher (OR\u2009=\u20091.86, 95% CI: 1.51, 1.96). A similar positive correlation was also observed for cadmium level and daytime sleepiness. However, no relationship was noted between cadmium and excessive sleep duration (\u22659\u2009h). A linear dose\u2013response relationship was found between cadmium concentration and the risk of insufficient sleeping (P non-linearity\u2009=\u20090.321), OSA symptoms (P non-linearity\u2009=\u20090.176), trouble sleeping (P non-linearity\u2009=\u20090.682) and daytime sleepiness (P non-linearity\u2009=\u20090.565). Additionally, no significant interactions between cadmium concentrations and subgroup variables were identified (P for interaction&amp;gt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Insufficient sleep, symptoms of OSA, trouble sleeping and daytime sleepiness were found to have a positive association with the blood cadmium concentration in US adults. However, further prospective studies are necessary to establish whether there is a causal relationship between these factors.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1476383","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T12:13:49Z","timestamp":1729858429000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Analysis of the relationship between sleep-related disorders and cadmium in the US population"],"prefix":"10.3389","volume":"12","author":[{"given":"Zhuanbo","family":"Luo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunlong","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"154","DOI":"10.3390\/ijerph18116154","article-title":"Sleep duration and waking activities in relation to the National Sleep Foundation's recommendations: an analysis of US population sleep patterns from 2015 to 2017","volume":"18","author":"Mireku","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1185\/030079905X65637","article-title":"An international survey of insomnia: under-recognition and under-treatment of a polysymptomatic condition","volume":"21","author":"Leger","year":"2005","journal-title":"Curr Med Res Opin"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"133","DOI":"10.4103\/1463-1741.181996","article-title":"Exposures to road traffic, noise, and air pollution as risk factors for type 2 diabetes: a feasibility study in Bulgaria","volume":"18","author":"Dzhambov","year":"2016","journal-title":"Noise Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1186\/s12889-021-10206-z","article-title":"Subjective sleep quality and association with depression syndrome, chronic diseases and health-related physical fitness in the middle-aged and elderly","volume":"21","author":"Hsu","year":"2021","journal-title":"BMC Public Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1093\/sleep\/zsy122","article-title":"Association between long-term exposure to air pollution and sleep disorder in Chinese children: the seven northeastern cities study","volume":"41","author":"Lawrence","year":"2018","journal-title":"Sleep"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"105205","DOI":"10.1016\/j.envint.2019.105205","article-title":"Is long-term exposure to air pollution associated with poor sleep quality in rural China?","volume":"133","author":"Chen","year":"2019","journal-title":"Environ Int"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1164\/rccm.202204-0740OC","article-title":"Early-life exposure to PM(2.5) and sleep disturbances in preschoolers from 551 cities of China","volume":"207","author":"Cai","year":"2023","journal-title":"Am J Respir Crit Care Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"41175","DOI":"10.1007\/s11356-020-10539-z","article-title":"Environmental neurotoxic pollutants: review","volume":"27","author":"Iqubal","year":"2020","journal-title":"Environ Sci Pollut Res Int"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"425","DOI":"10.3390\/atmos12040425","article-title":"Particulate matter and associated metals: a link with neurotoxicity and mental health","volume":"12","author":"Potter","year":"2021","journal-title":"Atmosphere"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1289\/ehp.0901234","article-title":"Cadmium, environmental exposure, and health outcomes","volume":"118","author":"Satarug","year":"2010","journal-title":"Environ Health Perspect"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1289\/ehp.1104020","article-title":"Reduction in cadmium exposure in the United States population, 1988-2008: the contribution of declining smoking rates","volume":"120","author":"Tellez-Plaza","year":"2012","journal-title":"Environ Health Perspect"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"802","DOI":"10.3390\/nu14040802","article-title":"Trends in urinary and blood cadmium levels in U.S. adults with or without comorbidities, 1999-2018","volume":"14","author":"Yang","year":"2022","journal-title":"Nutrients"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"103219","DOI":"10.1016\/j.etap.2019.103219","article-title":"Toxicity of cadmium in musculoskeletal diseases","volume":"72","author":"Reyes-Hinojosa","year":"2019","journal-title":"Environ Toxicol Pharmacol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"113361","DOI":"10.1016\/j.envpol.2019.113361","article-title":"Cadmium and kidney function: concentrations, variabilities, and associations across various stages of glomerular function","volume":"256","author":"Jain","year":"2020","journal-title":"Environ Pollut"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2927","DOI":"10.1126\/scitranslmed.aba2927","article-title":"Citrullinated vimentin mediates development and progression of lung fibrosis","volume":"13","author":"Li","year":"2021","journal-title":"Sci Transl Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"441","DOI":"10.2147\/COPD.S152028","article-title":"Cadmium nanoparticles citrullinate cytokeratins within lung epithelial cells: cadmium as a potential cause of citrullination in chronic obstructive pulmonary disease","volume":"13","author":"Hutchinson","year":"2018","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"67007","DOI":"10.1289\/EHP8523","article-title":"Cadmium exposure and coronary artery atherosclerosis: a cross-sectional population-based study of Swedish middle-aged adults","volume":"129","author":"Barregard","year":"2021","journal-title":"Environ Health Perspect"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"127004","DOI":"10.1289\/EHP7598","article-title":"Environmental cadmium and mortality from influenza and pneumonia in U.S. adults","volume":"128","author":"Park","year":"2020","journal-title":"Environ Health Perspect"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"899","DOI":"10.3390\/jcm12123899","article-title":"The effect of cadmium on sleep parameters assessed in polysomnographic studies: a case-control study","volume":"12","author":"Frosztega","year":"2023","journal-title":"J Clin Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1186\/s12889-023-16358-4","article-title":"Mitigation role of physical exercise participation in the relationship between blood cadmium and sleep disturbance: a cross-sectional study","volume":"23","author":"You","year":"2023","journal-title":"BMC Public Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2149","DOI":"10.2105\/AJPH.2021.306517","article-title":"The National Health and nutrition examination survey (NHANES), 2021-2022: adapting data collection in a COVID-19 environment","volume":"111","author":"Paulose-Ram","year":"2021","journal-title":"Am J Public Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.sleh.2015.10.004","article-title":"National Sleep Foundation's updated sleep duration recommendations: final report","volume":"1","author":"Hirshkowitz","year":"2015","journal-title":"Sleep Health"},{"key":"ref23","volume-title":"Healthy People [Internet]","year":"2020"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.tjnut.2023.11.012","article-title":"Manganese and sleep outcomes in United States adults: results from the 2017-2020 National Health and nutrition examination survey (NHANES)","volume":"154","author":"Yang","year":"2024","journal-title":"J Nutr"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1186\/s12888-023-05286-7","article-title":"Analysis of the relationship between sleep-related disorder and systemic immune-inflammation index in the US population","volume":"23","author":"Kadier","year":"2023","journal-title":"BMC Psychiatry"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1111\/j.1369-1600.2012.00487.x","article-title":"Impaired sleep quality and sleep duration in smokers-results from the German multicenter study on nicotine dependence","volume":"19","author":"Cohrs","year":"2014","journal-title":"Addict Biol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1002\/hep4.1803","article-title":"Inverse Association of Telomere Length with Liver Disease and Mortality in the US population","volume":"6","author":"Rattan","year":"2022","journal-title":"Hepatol Commun"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"167","DOI":"10.7326\/M20-1340","article-title":"Peripheral neuropathy and all-cause and cardiovascular mortality in U.S. adults: a prospective cohort study","volume":"174","author":"Hicks","year":"2021","journal-title":"Ann Intern Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.sleh.2022.05.005","article-title":"Antimony and sleep health outcomes: NHANES 2009-2016","volume":"8","author":"Cavallino","year":"2022","journal-title":"Sleep Health"},{"key":"ref30","year":""},{"key":"ref31","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1080\/09603123.2013.835032","article-title":"Cellular mechanisms of cadmium-induced toxicity: a review","volume":"24","author":"Rani","year":"2014","journal-title":"Int J Environ Health Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1159\/000102047","article-title":"The effects of chronic cadmium toxicity on the hemostatic system","volume":"35","author":"Kocak","year":"2006","journal-title":"Pathophysiol Haemost Thromb"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"695484","DOI":"10.3389\/fimmu.2021.695484","article-title":"Effects of cadmium exposure on the immune system and Immunoregulation","volume":"12","author":"Wang","year":"2021","journal-title":"Front Immunol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2601","DOI":"10.18502\/ijph.v50i12.7945","article-title":"High blood cadmium level in short sleepers: results from the 2008-2013 Korean National Health and nutrition survey","volume":"50","author":"Yeo","year":"2021","journal-title":"Iran J Public Health"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1007\/s11325-014-1045-2","article-title":"Serum levels of trace minerals and heavy metals in severe obstructive sleep apnea patients: correlates and clinical implications","volume":"19","author":"Asker","year":"2015","journal-title":"Sleep Breath"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"118217","DOI":"10.1016\/j.envres.2024.118217","article-title":"Association between exposure to heavy metals in atmospheric particulate matter and sleep quality: a nationwide data linkage study","volume":"247","author":"Kim","year":"2024","journal-title":"Environ Res"},{"key":"ref37","first-page":"408","article-title":"The effect of cadmium on the structure of the circadian cycle of waking-sleep and on the EEG in Wistar rats","volume":"30","author":"Vataev","year":"1994","journal-title":"Zh Evol Biokhim Fiziol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1007\/s10735-012-9414-2","article-title":"Lead neurotoxicity: effects on brain nitric oxide synthase","volume":"43","author":"Nava-Ruiz","year":"2012","journal-title":"J Mol Histol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"8244","DOI":"10.1007\/s11356-016-6333-x","article-title":"A review of toxicity and mechanisms of individual and mixtures of heavy metals in the environment","volume":"23","author":"Wu","year":"2016","journal-title":"Environ Sci Pollut Res Int"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1002\/jat.2853","article-title":"Acute enhancement of non-rapid eye movement sleep in rats after drinking water contaminated with cadmium chloride","volume":"34","author":"Unno","year":"2014","journal-title":"J Appl Toxicol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1093\/brain\/awg014","article-title":"Lead neurotoxicity in children: basic mechanisms and clinical correlates","volume":"126","author":"Lidsky","year":"2003","journal-title":"Brain"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1038\/nrneurol.2014.206","article-title":"'The clocks that time us'\u2014circadian rhythms in neurodegenerative disorders","volume":"10","author":"Videnovic","year":"2014","journal-title":"Nat Rev Neurol"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1476383\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T12:13:52Z","timestamp":1729858432000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1476383\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,25]]},"references-count":42,"alternative-id":["10.3389\/fpubh.2024.1476383"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2024.1476383","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,25]]},"article-number":"1476383"}}