Associations of serum zinc, copper, and selenium with sleep disorders in the American adults: Data from NHANES 2011–2016


Even though various studies have been conducted to investigate the relationship between trace metals and sleep, few epidemiological studies have evaluated the relationship between trace metals and sleep disorders in American adults.


This study intended to evaluate the associations of serum zinc (Zn), copper (Cu), selenium (Se), Zn/Cu, Zn/Se, and Cu/Se ratios with sleep disorders in American adults.


We conducted a cross-sectional analysis of 3660 adults aged ≥18 years old who participated in the National Health and Nutrition Examination Survey (NHANES) 2011–2016. Binary logistic regression was employed to calculate the odds ratio (OR) and 95 % confidence interval (CI) of either serum trace metals or serum trace metals ratios with risks among sleep disorder phenotypes. The restricted cubic spline (RCS) model was additionally utilized to check the dose-response relationships between serum trace metals, serum trace metals ratios, and sleep disorders.


Logistic regression demonstrated that higher serum Zn (OR: 0.70, 95 % CI: 0.51–0.97, p = 0.035), Zn/Cu (OR: 0.62, 95 % CI: 0.45–0.87, p = 0.007), and Zn/Se (OR: 0.68, 95 % CI: 0.49–0.95, p = 0.025) were related to a decreased likelihood of self-reported sleep disorders, and dose-response relationships were detected by the RCS models, after adjustment for sociodemographic, behavioral, and health characteristics. No associations between serum Cu, Se, Cu/Se, and sleep disorders were observed. The findings in the sensitivity analyses were consistent with these results.


Our study revealed that serum Zn, Zn/Cu, and Zn/Se were inversely associated with the risk of self-reported sleep disorders in US adults.