Abstract
BackgroundThe 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.MethodsData 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.ResultsThere 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.ConclusionsThis 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.
Highlights
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
In a more recent meta-analysis [13], reviewing 15 studies on adolescents (10–19 years) investigating the effect of short sleep duration on overweight and obesity, it was concluded that the current evidence was inconclusive as to whether sleep duration was related to adolescent overweight, mainly due to methodological concerns
BMI and sleep As detailed in Table 2, there was a u-shaped association between BMI category and most sleep parameters
Summary
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. Both sleep problems and obesity in adolescence are growing public health concerns. Four longitudinal studies have examined this link, but the results were inconsistent regarding short sleep duration as an independent risk factor for later obesity among adolescents [9,10,11,12]. In addition to the link between obesity and sleep duration, there is ample evidence for obesity as a risk factor for sleep disordered breathing in clinical samples [14]
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