Abstract Background Epidemiological evidence suggests that inadequate sleep duration and insomnia may be associated with increased risk of metabolic syndrome (MetS). However, longitudinal data with repeated measures of sleep duration and insomnia and of MetS are limited. We examined the association of sleep duration and insomnia with MetS and its components using longitudinal data from the Women’s Health Initiative (WHI). Methods The study included postmenopausal women (ages 50–79 years) diabetes-free at enrollment in the WHI, with baseline data on sleep duration (n = 5,159), insomnia (n = 5,063), MetS, and its components. Repeated measures of self-reported sleep duration and insomnia were available from years 1 or 3 of follow-up and of the MetS components from years 3, 6 and 9. Associations were assessed using logistic regression and generalized estimating equations models, and odds ratios and 95% confidence intervals (CI) adjusted for major risk factors were calculated. Results In cross-sectional analysis, baseline sleep duration ≥ 9 h was positively associated with MetS (OR = 1.51; 95%CI 1.12–2.04), while sleep duration of 8- 88 cm and triglycerides ≥ 150 mg/dL (OR = 1.18; 95%CI 1.01–1.40 and OR = 1.23; 95%CI 1.05–1.46, respectively). Insomnia had a borderline positive association with MetS (OR = 1.14; 95%CI 0.99–1.31), and significant positive associations with waist circumference > 88 cm and glucose ≥ 100 mg/dL (OR = 1.18; 95%CI 1.03–1.34 and OR = 1.17; 95%CI 1.02–1.35, respectively). In the longitudinal analysis, change from restful sleep to insomnia over time was associated with increased odds of developing MetS (OR = 1.40; 95%CI 1.01–1.94), and of a triglyceride level ≥ 150 mg/dL (OR = 1.48; 95%CI 1.08–2.03). Conclusions Among postmenopausal women in the WHI, sleep duration and insomnia were associated with current and future risk of MetS and some of its components.
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