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

BMC Pediatrics

Mari Hysing³  Liv Sand³  Ståle Pallesen²  Børge Sivertsen¹ 

[1] Department of Psychiatry, Helse Fonna HF, P.O. Box 2170, Haugesund N-5504, Norway;Norwegian Competence Center for Sleep Disorders, Jonas Lies vei 65, Bergen 5021, Norway;The Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health, Uni Research Bergen, P.O. Box 7810, Bergen N-5020, Norway

关键词: Epidemiology;    Adolescence;    Insomnia;    Sleep duration;    Sleep;    Underweight;    Overweight;    Obesity;    Body mass index;   

Others  :  1137314
DOI  :  10.1186/1471-2431-14-204

 received in 2014-06-18, accepted in 2014-08-11,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Sivertsen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 2.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA 2012, 307(5):483-490.
• [2]Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM, Johnson CL: Overweight prevalence and trends for children and adolescents. The national health and nutrition examination surveys, 1963 to 1991. Arch Pediatr Adolesc Med 1995, 149(10):1085-1091.
• [3]Stein CJ, Colditz GA: The epidemic of obesity. J Clin Endocrinol Metab 2004, 89(6):2522-2525.
• [4]National Sleep Foundation: 2005 Sleep in America Poll. National Sleep Foundation Web site. Available at: http://sleepfoundation.org/sleep-polls-data/sleep-in-america-poll/2005-adult-sleep-habitsand-styles webcite. Accessed January 31, 2014
• [5]Matricciani LA, Olds TS, Blunden S, Rigney G, Williams MT: Never enough sleep: a brief history of sleep recommendations for children. Pediatrics 2012, 129(3):548-556.
• [6]Matricciani L, Olds T, Williams M: A review of evidence for the claim that children are sleeping less than in the past. Sleep 2011, 34(5):651-659.
• [7]Pallesen S, Hetland J, Sivertsen B, Samdal O, Torsheim T, Nordhus IH: Time trends in sleep-onset difficulties among Norwegian adolescents: 1983–2005. Scand J Public Health 2008, 36(8):889-895.
• [8]Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S, Miller MA: Meta-analysis of short sleep duration and obesity in children and adults. Sleep 2008, 31(5):619-626.
• [9]Calamaro CJ, Park S, Mason TB, Marcus CL, Weaver TE, Pack A, Ratcliffe SJ: Shortened sleep duration does not predict obesity in adolescents. J Sleep Res 2010, 19(4):559-566.
• [10]Mitchell JA, Rodriguez D, Schmitz KH, Audrain-McGovern J: Sleep duration and adolescent obesity. Pediatrics 2013, 131(5):e1428-e1434.
• [11]Seegers V, Petit D, Falissard B, Vitaro F, Tremblay RE, Montplaisir J, Touchette E: Short sleep duration and body mass index: a prospective longitudinal study in preadolescence. Am J Epidemiol 2011, 173(6):621-629.
• [12]Silva GE, Goodwin JL, Parthasarathy S, Sherrill DL, Vana KD, Drescher AA, Quan SF: Longitudinal association between short sleep, body weight, and emotional and learning problems in Hispanic and Caucasian children. Sleep 2011, 34(9):1197-1205.
• [13]Guidolin M, Gradisar M: Is shortened sleep duration a risk factor for overweight and obesity during adolescence? A review of the empirical literature. Sleep Med 2012, 13(7):779-786.
• [14]Verhulst SL, Schrauwen N, Haentjens D, Suys B, Rooman RP, Van Gaal L, De Backer WA, Desager KN: Sleep-disordered breathing in overweight and obese children and adolescents: prevalence, characteristics and the role of fat distribution. Arch Dis Child 2007, 92(3):205-208.
• [15]Meyer KA, Wall MM, Larson NI, Laska MN, Neumark-Sztainer D: Sleep duration and BMI in a sample of young adults. Obesity 2012, 20(6):1279-1287.
• [16]Hysing M, Pallesen S, Stormark KM, Lundervold AJ, Sivertsen B: Sleep patterns and insomnia among adolescents: a population-based study. J Sleep Res 2013, 22(5):549-556.
• [17]Stormark KM, Heiervang E, Heimann M, Lundervold A, Gillberg C: Predicting nonresponse bias from teacher ratings of mental health problems in primary school children. J Abnorm Child Psychol 2008, 36(3):411-419.
• [18]Cole TJ, Flegal KM, Nicholls D, Jackson AA: Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 2007, 335(7612):194.
• [19]Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000, 320(7244):1240-1243.
• [20]Lichstein KL, Durrence HH, Taylor DJ, Bush AJ, Riedel BW: Quantitative criteria for insomnia. Behav Res Ther 2003, 41(4):427-445.
• [21]Sivertsen B, Overland S, Glozler N, Bjorvatn B, Maeland JG, Mykletun A: The effect of OSAS on sick leave and work disability. Eur Respir J 2008, 32(6):1497-1503.
• [22]Sivertsen B, Bjornsdottir E, Overland S, Bjorvatn B, Salo P: The joint contribution of insomnia and obstructive sleep apnoea on sickness absence. J Sleep Res 2013, 22(2):223-230.
• [23]Thapar A, McGuffin P: Validity of the shortened mood and feelings questionnaire in a community sample of children and adolescents: a preliminary research note. Psychiatry Res 1998, 81(2):259-268.
• [24]Sharp C, Goodyer IM, Croudace TJ: The short mood and feelings questionnaire (SMFQ): a unidimensional item response theory and categorical data factor analysis of self-report ratings from a community sample of 7-through 11-year-old children. J Abnorm Child Psychol 2006, 34(3):379-391.
• [25]Lundervold AJ, Posserud M, Stormark K, Breivik B, Hysing M: Symptoms of depression as reported by Norwegian adolescents on the short mood and feelings questionnaire. Front Psychol 2013, 4:613.
• [26]Currie C: Health behaviour in school-aged children. A WHO cross-national survey (HBSC). research protocol for the 1997–1998 study. Edinburgh: University of Edinburgh; 1998.
• [27]Booth ML, Okely AD, Chey T, Bauman A: The reliability and validity of the physical activity questions in the WHO health behaviour in schoolchildren (HBSC) survey: a population study. Br J Sports Med 2001, 35(4):263-267.
• [28]Danielsen YS, Pallesen S, Stormark KM, Nordhus IH, Bjorvatn B: The relationship between school day sleep duration and body mass index in Norwegian children (aged 10–12). Int J Pediatr Obes 2010, 5(3):214-220.
• [29]Singh M, Drake C, Roehrs T, Hudgel D, Roth T: The association between obesity and short sleep duration: a population based study. J Clin Sleep Med 2005, 1:357-363.
• [30]Taheri S, Lin L, Austin D, Young T, Mignot E: Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index (BMI). Sleep 2004, 27:146-147.
• [31]Bjorvatn B, Sagen IM, Oyane N, Waage S, Fetveit A, Pallesen S, Ursin R: The association between sleep duration, body mass index and metabolic measures in the Hordaland Health Study. J Sleep Res 2007, 16(1):66-76.
• [32]Spiegel K, Tasali E, Penev P, Van Cauter E: Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated Ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004, 141(11):846-850.
• [33]Omisade A, Buxton OM, Rusak B: Impact of acute sleep restriction on cortisol and leptin levels in young women. Physiol Behav 2010, 99(5):651-656.
• [34]Weiss A, Xu F, Storfer-Isser A, Thomas A, Ievers-Landis CE, Redline S: The association of sleep duration with adolescents’ fat and carbohydrate consumption. Sleep 2010, 33(9):1201-1209.
• [35]Taheri S: The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity. Arch Dis Child 2006, 91(11):881-884.
• [36]Baron KG, Reid KJ, Zee PC: Exercise to improve sleep in insomnia: exploration of the bidirectional effects. J Clin Sleep Med 2013, 9(8):819-824.
• [37]Patel SR, Hu FB: Short sleep duration and weight gain: a systematic review. Obesity 2008, 16(3):643-653.
• [38]Vaher H, Kasenomm P, Vasar V, Veldi M: A survey of parentally reported sleep health disorders in estonian 8–9 year old children. BMC Pediatr 2013, 13:200.
• [39]Kang KT, Lee PL, Weng WC, Hsu WC: Body weight status and obstructive sleep apnea in children. Int J Obes (Lond) 2012, 36(7):920-924.
• [40]Lauer CJ, Krieg JC: Sleep in eating disorders. Sleep Med Rev 2004, 8(2):109-118.
• [41]Goodman E, Whitaker RC: A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics 2002, 110(3):497-504.
• [42]Sivertsen B, Salo P, Mykletun A, Hysing M, Pallesen S, Krokstad S, Nordhus IH, Overland S: The bidirectional association between depression and insomnia: the HUNT study. Psychosom Med 2012, 74(7):758-765.
• [43]Roberts RE, Roberts CR, Chen IG: Impact of insomnia on future functioning of adolescents. J Psychosom Res 2002, 53(1):561-569.
• [44]Buysse DJ: Insomnia state of the science: an evolutionary, evidence-based assessment. Sleep 2005, 28(9):1045-1046.
• [45]National Institutes of H: National institutes of health state of the science conference statement on manifestations and management of chronic insomnia in adults, June 13–15, 2005. Sleep 2005, 28(9):1049-1057.
• [46]Lytle LA, Pasch KE, Farbakhsh K: The relationship between sleep and weight in a sample of adolescents. Obesity 2011, 19(2):324-331.
• [47]Kohler MJ, Thormaehlen S, Kennedy JD, Pamula Y, van den Heuvel CJ, Lushington K, Martin AJ: Differences in the association between obesity and obstructive sleep apnea among children and adolescents. J Clin Sleep Med 2009, 5(6):506-511.
• [48]Wing YK, Hui SH, Pak WM, Ho CK, Cheung A, Li AM, Fok TF: A controlled study of sleep related disordered breathing in obese children. Arch Dis Child 2003, 88(12):1043-1047.
• [49]Skidmore PM, Howe AS, Polak MA, Wong JE, Lubransky A, Williams SM, Black KE: Sleep duration and adiposity in older adolescents from Otago, New Zealand: relationships differ between boys and girls and are independent of food choice. Nutr J 2013, 12(1):128.
• [50]Bowring AL, Peeters A, Freak-Poli R, Lim MS, Gouillou M, Hellard M: Measuring the accuracy of self-reported height and weight in a community-based sample of young people. BMC Med Res Methodol 2012, 12:175.
• [51]Gunnare NA, Silliman K, Morris MN: Accuracy of self-reported weight and role of gender, body mass index, weight satisfaction, weighing behavior, and physical activity among rural college students. Body Image 2013, 10(3):406-410.
• [52]Chan NP, Choi KC, Nelson EA, Sung RY, Chan JC, Kong AP: Self-reported body weight and height: an assessment tool for identifying children with overweight/obesity status and cardiometabolic risk factors clustering. Matern Child Health J 2013, 17(2):282-291.
• [53]Lauderdale DS, Knutson KL, Yan LL, Liu K, Rathouz PJ: Self-reported and measured sleep duration: how similar are they? Epidemiology 2008, 19(6):838-845.
• [54]Zinkhana M, Berger K, Hense S, Nagel A, Koch B, Penzele T, Fietzee I: Agreement of different methods for assessing sleep characteristics: a comparison of two actigraphs, wrist and hip placement, and self-report with polysomnography. Sleep Med2014 May 28 [Epub ahead of print]
• [55]Dillon HR, Lichstein KL, Dautovich ND, Taylor DJ, Riedel BW, Bush AJ: Variability in Self-Reported Normal Sleep Across the Adult Age Span. J Gerontol B Psychol Sci Soc Sci 2014. May 13 [Epub ahead of print]
• [56]Kong AP, Wing YK, Choi KC, Li AM, Ko GT, Ma RC, Tong PC, Ho CS, Chan MH, Ng MH, Lau J, Chan JC: Associations of sleep duration with obesity and serum lipid profile in children and adolescents. Sleep Med 2011, 12(7):659-665.
• [57]Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP: Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol 2003, 88(5):879-903.
• [58]Morton SMB, Bandara DK, Robinson EM, Carr PEA: In the 21st century, what is an acceptable response rate? Aust N Z J Public Health 2012, 36(2):106-108.
• [59]The Directorate of Integration and Diversity (IMDi): [Education participation in high schools]. 2014. Available at: http://www.imdi.no/no/Fakta-og-statistikk/Fakta-og-statistikk/Utdanning/ webcite. Accessed March 3