Sleep and body mass index in adolescence: results from a large population-based study of Norwegian adolescents aged 16 to 19 years

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.

The Association between Self-reported Sleep Duration and Body Mass Index among Korean Adolescents

“…In a study of European adolescents, shorter sleep duration was associated with higher levels of adiposity markers including BMI, body fat, and waist circumferences (21). In the study of Norwegian adolescents, short sleep is associated with BMI, but the association was stronger in girls similarly to our results (22). Another study focused on the effect of weekend sleep compensation on weight with the results that increased weekend catch-up sleep may reduce the risk of overweight and obesity (23), which were partially consistent with the present results.…”

Effect of Sleep Duration, Diet, and Physical Activity on Obesity and Overweight Elementary School Students in Shanghai

“…Our findings indicate that in Shanghai, the majority of school‐age children sleep <10 hours/day both on school and non‐school days, and that <10 hours of sleep is associated with being overweight or obese. The importance of sleep duration and activity time on weight has also been found in other studies from different geographical regions . The study of Firouze et al (2014) evaluated factors that influence obesity in children (N = 164) (6 to 12 years of age) from Malaysia, and found that children with the shortest sleep time had a 4.5 times higher chance of being overweight or obese compared with children with normal sleep duration.…”

Sleep quality and obesity in young subjects: a meta‐analysis

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“…The lowest scoring study had 12 points deducted while the highest scoring study had no points deducted resulting in a score of 17. There were ten studies comprising the middle two quartiles (scores 9 – 11) , two studies in the lowermost quartile (scores 5 – 7) and six studies in the uppermost quartile (scores 12 – 17) .…”

“…Of the deficits in bias safeguards, the most common was a lack of clarity about eligibility criteria, but a few studies did provide this information. Other deficits included not adjusting for the role of potential confounders However; all longitudinal studies accounted for missing data and compared the sample with complete data with the sample without complete data.…”