Direct and Indirect Relationships Between Impaired Sleep, Obesity Risk Factors and Overweight and Obesity
Abstract PurposeThe relationship between impaired sleep and overweight/obesity may be explained by sleep-disrupting behaviour that are practised by overweight people (e.g. night-eating, insufficient physical activity [PA], electronic device use) and stress/affective distress. Thus, we evaluated whether sleep parameters predicted overweight/obesity after taking into account the behaviour and affective state.MethodsOnline questionnaires asked about sleep quality, night-eating, PA, electronic device use and stress/affective distress at T1 (baseline) and T2 (3-months later). Height, weight and waist and hip circumference were measured. PA and sleep were assessed over 24-hours on two occasions using actigraphy in 161 participants at T1 and T2.ResultsAt T1, high body mass index (BMI)/waist-to-hip ratio (WHR) and obesity category were together related to more sleep disturbances (subjective) and longer awake time (objective), after controlling covariates (e.g. watching TV) and demographics (e.g. older age, male gender). At T2, high WHR was predicted by older age and male gender after controlling T1 WHR, demographics and covariates. Mediational analyses showed that sleep disturbances mediated nocturnal indigestion (NI) to BMI, poor subjective sleep quality mediated NI to WHR and high daytime dysfunction mediated NI to obesity category relationships.ConclusionMore time spent awake during the night (experienced as more sleep disturbances) was related to overweight/obesity indices even after taking into account other obesity risk factors (e.g. night-eating, insufficient PA, affect) and demographics. Mediational results suggest that NI parsimoniously explained the impaired sleep - overweight/obesity relationship.Level of Evidence: Level III, evidence obtained from well-designed cohort.