Is sleep duration associated with overweight/obesity in Indigenous Australian adults?

Abstract

Background: Associations between high BMI and sleep duration and chronic illness are recognised. Short sleep is an accepted predictor of high BMI for children, including Indigenous Australian children. Short sleep has also been associated with high BMI in Australian adults, although not specifically in Indigenous Australian adults. This study aims to determine whether the relationship between sleep duration and BMI observed in non-Indigenous adults holds for Indigenous adults. Methods: Data collected from 5204 non-Indigenous and 646 Indigenous participants aged over 18 years in a nationally representative Australian Health Survey 2011-2013 were analysed. Sleep duration was self-reported as the time between going to bed and time waking up; BMI was derived from measurement and categorised into normal weight (BMI = 18.5-24.9) and overweight/obese (BMI ≥ 25). Logistic regression was performed for the non-Indigenous and Indigenous groups separately to examine the association between sleep duration and BMI in each group. Results: Proportionally more Indigenous people were classified as overweight/obese than non-Indigenous (χ 2 = 21.81, p < 0.001). Short sleep was reported by similar proportions in both groups (Indigenous 15% vs non-Indigenous 17%) whereas long sleep of > 9 h was reported by proportionally more Indigenous than non-Indigenous people (41% vs 26%). Without accounting for possible confounders, the association between sleep duration and BMI for the Indigenous group was not significant but a possible dose-response relationship was evident, with the odds of overweight/obesity being greatest for those who typically slept < 7 h (OR = 1.77, 95% CI 0.38-3.94) and < 6 h (OR = 1.55, 95%CI = 0.58-4.14). The same model for the non-Indigenous group was significant, with the odds of overweight/obesity being greatest for those who typically slept < 6 h (OR = 1.67, 95%CI 1.25-2.25). The risk of overweight/obesity diminished for both groups with sleep > 7 h. Accounting for a range of socioeconomic and personal confounders attenuated the strength of these relationships marginally. Conclusion: Adding to reports relating sleep duration and BMI for Australian adults, this study provides evidence for an inverse relationship in non-Indigenous adults and suggests a similar trend for Indigenous adults. This trend was non-significant but is consistent with previous results for Indigenous children.

Association between indigenous status and Body Mass Index (BMI) in Australian adults: Does sleep duration affect the relationship?

“…Consistent with previous reports [ 48 ], and as we have previously described [ 21 ], increased BMI was independently associated with short sleep duration of less than 7 hours, but not with long sleep of greater than 9 hours. Notably, after accounting for possible confounding influences, Indigenous status was a significant predictor of BMI.…”

“…This study used the same dataset and followed on from our previous report [ 21 ]. In short, the dataset from participants in the Australian Health Survey (AHS) and the complementary Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) was provided by the Australian Bureau of Statistics (ABS).…”

“…As a follow on from the previous study, the same measures were employed [ 21 ] with the addition of lifestyle variables related to diet, physical activity and smoking status. In short, sleep duration was subjectively reported and declared as a typical night’s sleep.…”

“…Associations between sleep duration and BMI in the general Australian adult population (including Indigenous people) have been reported [ 17 , 18 ], however to date, information about sleep duration specific to Indigenous Australians remains scant [ 19 ]. Lack of sleep has previously been identified as an issue of concern by one group of Australian Indigenous people [ 20 ] and our recent study of Australian adults showed that less than 7 hours sleep duration predicted obesity for both Indigenous and non-Indigenous adults [ 21 ]. However, it remains unknown if differences in sleep duration account for any of the variation in BMI between Indigenous and non-Indigenous Australian adults.…”

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“…Moreover, those with negative changes in sleep quality reported more weight gain than those with positive changes [ 4 ]. With regards to the relationship of sleep duration with weigh status in Australians, it was found that the odds of overweight/obesity were the greatest for those who slept <6 h, and the risk of overweight/obesity decreased for those with sleep >7 h [ 13 ]. Moreover, compared with recommended sleep time (i.e., ≥7 to ≤9 h) in U.S., American black women who were very short sleepers (≤6 h) and long sleepers (>9 h) had a significantly greater body mass index (BMI) [ 14 ].…”