The association between obesity and short sleep duration: A population-based study

Henry Ford Hospital Sleep Disorders and Research Center, Wayne State College of Medicine, Detroit, MI 49202, USA.
Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine (Impact Factor: 3.05). 10/2005; 1(4):357-63.
Source: PubMed


To assess the association between nightly total sleep time (TST) and obesity in an epidemiologic sample of metropolitan Detroit, Michigan.
Data were collected through telephone interviews completed using a population-based sample of 3158. The self-reported average nightly TST during the 2 weeks before the interview was used to divide the sample into 6 groups (hours per night of sleep; < or = 5, > 5 < or = 6, > 6 < or = 7, > 7 < or = 8, > 8 < or = 9, > 9). Obesity was defined as a body mass index > or = 30. Health and demographic variables were also assessed.
The overall prevalence of obesity was 24.8% and was significantly higher in individuals with lower amounts of TST. Compared with those with 7 to 8 hours of TST, individuals obtaining 5 hours or less and more than 5 but 6 hours or less of TST had significantly increased odds of being obese, after controlling for age, sex, loud snoring, hypertension, diabetes, arthritis, and alcohol intake (odds ratio = 1.7, 95% confidence interval = 1.3-2.3 and odds ratio = 1.4, 95% confidence interval = 1.1-1.8, respectively). A low TST was a significant predictor of a high body mass index. Furthermore, a low TST was also a significant predictor of diabetes, prior to controlling for body mass index. Interestingly, the prevalence of reduced habitual TST (< or = 5 hours) was higher in African Americans, in comparison with Caucasians (18.7% vs 7.4%; p < .001).
Our population-based data suggest that short sleep duration is associated with elevated prevalence of obesity and adds to the growing body of evidence supporting this relationship.

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Available from: Christopher Drake, May 22, 2014
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    • "The finding of a U-shaped association between sleep duration and BMI has to the best of our knowledge not been previously demonstrated in adolescents, although it is in accordance with the only previous study investigating this in children [28], as well as with several studies on adults [29-31]. There are several potential pathways, both biological and behavioral, that may explain how sleep problems duration may be related to overweight/obesity. "
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    ABSTRACT: Background The aim of this study was to examine the association between body mass index (BMI) and sleep duration, insomnia and symptoms of obstructive sleep apnea (OSA) in adolescents. Methods Data were taken from a large population based study of 9,875 Norwegian adolescents aged 16–19. BMI was calculated from the self-reported body weight and categorized according to recommended age and gender specific cut offs for underweight, overweight and obesity. Detailed sleep parameters (sleep duration, insomnia, and OSA symptoms) were reported separately for weekdays and weekends. Data were analyzed using Pearson’s chi-squared test and ANOVAs for simple categorical and continuous comparisons, and multinomial logistic regressions for analyses adjusting for known confounders. Results There was evidence for a curvilinear relationship between BMI and both sleep duration and insomnia for girls, whereas the relationship was linear for boys. Compared to the average weekday sleep duration among adolescents in the normal weight range (6 hrs 29 min), both underweight (5 hrs 48 min), overweight (6 hrs 13 min) and obese (5 hrs 57 min) adolescents had shorter sleep duration. OSA symptoms were linearly associated with BMI. Controlling for demographical factors as well as physical activity did not attenuate the associations. Additional adjustment for depression reduced the association between insomnia and obesity to a non-significant level. The evidence for a link between both underweight and overweight/obesity, and short sleep duration and OSA symptoms remained in the fully adjusted analyses. The associations were generally stronger for girls. Conclusions This is one of the first population-based studies to investigate the relationship between sleep and BMI in adolescents while simultaneously controlling for important confounding factors. These findings require further research to investigate the temporal association between weights and sleep problems.
    Full-text · Article · Aug 2014 · BMC Pediatrics
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    • "Over the last decade, several cross-sectional studies have shown associations between sleep duration, sleeping habits, and measurements of obesity [1] [2] [3] [4] [5] [6] [7] [8] [9]. An inverse relationship between selfreported sleep duration and obesity is found in adult men and women, as well as in children [10]. "
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    ABSTRACT: Objective: To assess how change in sleep duration is related to subsequent obesity. Methods: In this 10-year follow-up, 4903 non-pregnant participants answered a questionnaire on sleeping habits, obesity, and lifestyle factors (questions identical to baseline questionnaire). Habitual normal sleepers were defined as sleeping 6-9 h/night at both baseline and follow-up, whereas women sleeping <6 h/night or ≥9 h/night at both occasions were defined as habitual short sleepers and habitual long sleepers, respectively. Logistic regression was used to analyze associations between changes in sleep duration, general obesity (body mass index ≥30 kg/m(2)), weight gain (≥10 kg) and also, central obesity (waist circumference ≥88 cm), and increase in waist circumference (≥10 cm) at follow-up. Results: Among younger women (aged <40 years) both habitual short sleepers and habitual long sleepers had a higher prevalence of general (short: 31.3%, P < 0.0001; long: 38.1%, P = 0.01) and central obesity (short: 60.5%, P = 0.01; long: 82.4%, P = 0.01) compared with habitual normal sleepers (general obesity: 8.9%; central obesity: 35.9%) at follow-up. Younger women who were short sleepers at baseline but normal sleepers at the follow-up had a higher prevalence of both general (19.3%, P = 0.01) and central obesity (45.4%, P = 0.07) compared with habitual normal sleepers at follow-up. In adjusted analyses, both habitual short [adjusted odds ratio (aOR), 6.78; 95% confidence interval (CI), 2.71-17.0] and long (aOR, 4.64; 95% CI, 1.09-19.8) sleep durations were risk factors for general obesity in younger women. In younger women habitual long sleep duration was a risk factor also for central obesity (aOR, 6.05; 95% CI, 1.19-30.7) whereas habitual short sleep duration was not (aOR, 1.93; 95% CI, 0.87-4.81). Similar results were seen also for weight gain and increased waist circumference as dependent variables. In addition, decreased sleep duration from normal to short duration was a risk factor for both weight gain (aOR, 1.85; 95% CI, 1.14-3.02) and increased waist circumference (aOR, 1.84; 95% CI, 1.20-2.81). There were no associations between changes in sleep duration and any of the measures of obesity at the follow-up in women aged >40 years at baseline. Conclusion: In younger women, both habitual short and long sleep duration was a risk factor for obesity, whereas no such relationship was seen in older women.
    Full-text · Article · Jun 2014 · Sleep Medicine
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    • "Longer self-reported sleep has been associated with increased total cholesterol and a higher total/high-density lipoprotein cholesterol ratio among the elderly [74], greater carotid intimal medial thickness [75], recent treatment for cancer [62], having had a heart attack or angina [62], poorer cognitive function [76], having a history of depression [60], and using antidepressants [60]. Shorter self-reported sleep has been reported as associated with obesity [77e81], the metabolic syndrome [82] [83], diabetes [81], hypertension [84], cortisol secretion [85], poor general health [63], and having more medical conditions [86] [87]. Shorter self-reported sleep "
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    ABSTRACT: Purpose: Variation in sleep duration has been linked with mortality risk. The purpose of this review is to provide an updated evaluation of the literature on sleep duration and mortality, including a critical examination of sleep duration measurement and an examination of correlates of self-reported sleep duration. Methods: We conducted a systematic search of studies reporting associations between sleep duration and all-cause mortality and extracted the sleep duration measure and the measure(s) of association. Results: We identified 42 prospective studies of sleep duration and mortality drawing on 35 distinct study populations worldwide. Unlike previous reviews, we find that the published literature does not support a consistent finding of an association between self-reported sleep duration and mortality. Most studies have employed survey measures of sleep duration, which are not highly correlated with estimates based on physiologic measures. Conclusions: Despite a large body of literature, it is premature to conclude, as previous reviews have, that a robust, U-shaped association between sleep duration and mortality risk exists across populations. Careful attention must be paid to measurement, response bias, confounding, and reverse causation in the interpretation of associations between sleep duration and mortality.
    Full-text · Article · Apr 2013 · Annals of epidemiology
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