[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-455174-105":59,"doc-detail-455174-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","association-of-remnant-cholesterol-with-selfreported-trouble-sleeping-and-mediation-by-depression","Association of Remnant Cholesterol With Self‑Reported Trouble Sleeping and Mediation by Depression","","Remnant cholesterol (RC) is evaluated as an independent cardiovascular risk factor, with study focus on whether RC levels relate to trouble sleeping and whether depression explains (mediates) this association. Data from 14,617 U.S. adults in NHANES were analyzed, with RC calculated from total cholesterol minus HDL-c and LDL-c. Trouble sleeping was self-reported, and associations were tested using logistic regression, restricted cubic splines, and mediation analysis.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/association-of-remnant-cholesterol-with-selfreported-trouble-sleeping-and-mediation-by-depression/455174/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/association-of-remnant-cholesterol-with-selfreported-trouble-sleeping-and-mediation-by-depression/455174.png","ImageObject",300,407,{"name":92,"@type":93},"pop out","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How was remnant cholesterol (RC) calculated in this study?","Question",{"text":112,"@type":113},"RC was computed by subtracting both HDL-c and LDL-c from total cholesterol (TC) based on the lipid profile.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What method was used to assess the relationship between RC and trouble sleeping?",{"text":117,"@type":113},"Logistic regression, restricted cubic spline analysis, and mediation analysis were used to test the association and its shape.",{"name":119,"@type":110,"acceptedAnswer":120},"What role did depression play in the RC–trouble sleeping relationship?",{"text":121,"@type":113},"Depression partially mediated the relationship between RC levels and trouble sleeping.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},455174,1790794857,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090760408,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Brain and Behavior  \n| \u003Cbr> ORIGINAL ARTICLE \u003Cbr>Association of Remnant Cholesterol With Self‑Reported Trouble Sleeping and Mediation by Depression\u003Cbr>Qichao Yang1  Zhaoxiang Wang2  Han Yan1  Xuejing Shao1\u003Cbr>1 Department of Endocrinology, Affiliated Wujin Hospital of Jiangsu University, Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu,\u003Cbr>China  2 Department of Endocrinology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, China Correspondence: Xuejing Shao ([shaoxuejing@wjrmyy.cn](shaoxuejing@wjrmyy.cn))\u003Cbr>Received: 25 September 2025  Revised: 12 December 2025  Accepted: 26 December 2025\u003Cbr>Keywords: depression | linear relationship | dyslipidemia | remnant cholesterol | trouble sleeping\u003Cbr>\u003Cbr>ABSTRACT\u003Cbr>Purpose: Remnant cholesterol (RC) is an independent risk factor for cardiovascular diseases. The objective of this study is to assess the correlation between RC levels and trouble sleeping among U.S. adults.\u003Cbr>Methods: This study analyzed data from 14,617 adults enrolled in the National Health and Nutrition Examination Survey (NHANES), calculating RC by subtracting both high-density and low-density lipoprotein cholesterol (HDL-c and LDL-c) from total cholesterol (TC). Trouble sleeping was identified through self-report history. The relationship between RC and trouble sleeping was explored through logistic regression, restricted cubic spline (RCS), and mediation analysis.\u003Cbr>Results: The prevalence of trouble sleeping escalates with increasing RC levels. Adjusting for potential confounders, higher RC levels were significantly associated with an increased risk of trouble sleeping [OR (95% CI): 1.30 (1.13–1.49), p \u003C 0.001] . A linear relationship was identified through RCS analysis. Moreover, depression was found to partially mediate the relationship between RC and trouble sleeping.\u003Cbr>Conclusions: Trouble sleeping is associated with increased RC levels. The causal relationship requires additional investigation. |  |\n| --- | --- |\n| 1  Introduction\u003Cbr>As the pace of society continues to increase, sleep health has emerged as a significant concern for public health, with about one-third of the population expressing dissatisfaction with their sleep (Barnes and Drake 2015; Ohayon 2002; National Institutes of Health 2005) . Trouble sleeping, encompassing conditions like obstructive sleep apnea, issues related to sleep quality (including inadequate sleep, sleep duration, and insomnia), and a variety of other sleep issues, is progressively prevalent among adults in the United States (You et al. 2023; Sateia 2014) . These sleep issues often accompany physical or mental health conditions, such as dyslipidemia, metabolic disorders, depression, and cardiovascu- | lar diseases (Chaput et al. 2023; Shan et al. 2015; Miller and Howarth 2023; Chunnan et al. 2022; Drager et al. 2010) .\u003Cbr>Recent studies suggest that remnant cholesterol (RC), the cholesterol component found in triglyceride (TG)-rich lipoproteins (TRLs) like very-low-density lipoproteins, intermediate-density lipoproteins, and chylomicron remnants, may be a crucial factor in the development of atherosclerotic cardiovascular disease (ASCVD) (Quispe et al. 2021; Jørgensen et al. 2013) . Unlike lowdensity lipoprotein cholesterol (LDL-c), RC has been identified as having a more direct impact on cardiovascular health, marking itas a focal point in lipid management strategies (Quispe et al. 2021; Cao et al. 2023) . Furthermore, emerging research points to RC |\n| Qichao Yang and Zhaoxiang Wang contributed equally to this work. |  |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.\u003Cbr>© 2026 The Author(s). Brain and Behavior published by Wiley Periodicals LLC. |  |\n\nBrain and Behavior, 2026; 16:e71201 1 of 9  \n[https://doi.org/10.1002/brb3.71201](https://doi.org/10.1002/brb3.71201)  \nas a","cbCairNp8MO4b6EF","https://ap.wps.com/l/cbCairNp8MO4b6EF","pdf",918525,"English","# Introduction\n## Sleep health and trouble sleeping\n## RC as a lipid marker for cardiovascular disease\n# Materials and Methods\n## Study Population\n## Measures of Exposure and Outcome\n# Results\n# Discussion\n# Conclusion","[{\"question\":\"How was remnant cholesterol (RC) calculated in this study?\",\"answer\":\"RC was computed by subtracting both HDL-c and LDL-c from total cholesterol (TC) based on the lipid profile.\"},{\"question\":\"What method was used to assess the relationship between RC and trouble sleeping?\",\"answer\":\"Logistic regression, restricted cubic spline analysis, and mediation analysis were used to test the association and its shape.\"},{\"question\":\"What role did depression play in the RC–trouble sleeping relationship?\",\"answer\":\"Depression partially mediated the relationship between RC levels and trouble sleeping.\"}]","Association of Remnant Cholesterol With Self‑Reported Trouble Sleeping and Mediation by Depression | PDF",1790742264,23]