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. 2022;26(7):714-722.
doi: 10.1007/s12603-022-1823-7.

Age and Sex Differences in the Association of Sleep Duration and Overweight/Obesity among Chinese Participants Age above 45 Years: A Cohort Study

F Yao  1 , J Ma, P Qin, X Tu, X Li, X Tang
Affiliations

Age and Sex Differences in the Association of Sleep Duration and Overweight/Obesity among Chinese Participants Age above 45 Years: A Cohort Study

F Yao et al. J Nutr Health Aging. 2022.

Abstract

Objectives: We aimed to evaluate the association between sleep duration and obesity and estimate the attributable risk of sleep in the China Health and Retirement Longitudinal Study surveys (CHARLS).

Methods: A total of 9061 adults aged 45 years above from CHARLS (2011-2015) were included. The main outcome of this study was incident overweight/obesity specific to general and abdominal obesity. Overweight/obesity was defined as BMI ≥ 23.0 (kg/m2) and BMI≥27.5 (kg/m2), respectively. Abdominal obesity was defined as waist circumference ≥90 cm for men and ≥80 cm for women. Self-reported sleep durations were obtained using a structured questionnaire. We assessed hazard ratios (HRs) and 95% confidence intervals (CIs) as well as the population attributable fraction (PAF) for associations between sleep duration and obesity.

Results: 986 and 606 participants were identified as overweight and general obesity respectively, 1253 experienced abdominal obesity events. In multivariable-adjusted models, participants with daytime sleep of 0-30 minutes and more than 30 minutes associated with 30% (HR: 0.70, 95% CI: 0.56-0.87) and 35% (HR: 0.65, 95% CI: 0.55-0.78) decreased incident overweight risk respectively compared to those having no daytime sleep, this association also found among females and middle-aged, not males or elderly. Similarly, 0-30 minutes (HR: 0.68, 95% CI: 0.48-0.96) and more than 30 minutes of daytime sleep (HR: 0.73, 95% CI: 0.59-0.91) were associated with a reduced risk of abdominal obesity, similar results also found among females and middle-aged. Compared with 7-9 hours of nocturnal sleep, people who slept 5-7 hours had a reduced risk of overweight (HR: 0.59, 95% CI=0.47-0.74),but not found in subgroups. The hazard role of long nocturnal sleep for abdominal obesity was only found among elderly (HR: 2.33, 95% CI=1.35-4.04) and males (HR: 2.24, 95% CI=1.17-4.29). Compared with moderate total sleepers (7-9hours/day), participants with short total sleep duration exhibited an elevated risk of overweight (HR: 1.13, 95% CI=1.00-1.28), this also found among middle-aged. The PAF for inadequate total sleep duration (<7 hours/day) was 10.77% for overweight individuals.

Conclusions: Insufficient sleep duration was associated with an elevated risk of overweight only detected among middle-aged not elderly and other subgroups specific by age. The risks for abdominal obesity were increased for males and middle-aged with long nocturnal sleep. Daytime sleep may significantly reduce the risk of overweight and abdominal obesity in female and middle-aged individuals. The link between sleep duration and obesity requires further study.

Keywords: Overweight/obesity; daytime sleep; middle-aged and elderly; sleep duration.

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Conflict of interest statement

All other authors declare no competing interests. This research did not receive any funding from agencies.

Figures

Figure 1
Figure 1
The association between sleep duration and overweight by sex *Model 1 adujusted for age, sex, education, marital status, smoking, drinking, BMI at baseline, diabetes, hypertension, physical function, depression status, automobile possession, and region; **In addition to covariates in Model 1, daytime/nocturnal sleep duration and the interaction between daytime and nocturnal sleep duration were adjusted for in Model
Figure 2
Figure 2
The association between sleep duration and overweight by sex *Model 1 adjusted for age, sex, education, marital status, smoking, drinking, BMI at baseline, diabetes, hypertension, physical function, depression status, automobile possession, and region; **In addition to covariates in Model 1, daytime/nocturnal sleep duration and the interaction between daytime and nocturnal sleep duration were adjusted for in Model 2.
Figure 3
Figure 3
The association between sleep duration and general obesity by sex *Model 1 adjusted for age, sex, education, marital status, smoking, drinking, BMI at baseline, diabetes, hypertension, physical function, depression status, automobile possession, and region; **In addition to covariates in Model 1, daytime/nocturnal sleep duration and the interaction between daytime and nocturnal sleep duration were adjusted for in Model 2.
Figure 4
Figure 4
The association between sleep duration and general obesity by age *Model 1 adjusted for age, sex, education, marital status, smoking, drinking, BMI at baseline, diabetes, hypertension, physical function, depression status, automobile possession, and region; **In addition to covariates in Model 1, daytime/nocturnal sleep duration and the interaction between daytime and nocturnal sleep duration were adjusted for in Model 2.
Figure 5
Figure 5
The association between sleep duration and the incidence of abdominal obesity by sex *Model 1 adjusted for age, sex, education, marital status, smoking, drinking, BMI at baseline, diabetes, hypertension, physical function, depression status, automobile possession, and region; **In addition to covariates in Model 1, daytime/nocturnal sleep duration and the interaction between daytime and nocturnal sleep duration were adjusted for in Model 2.
Figure 6
Figure 6
The association between sleep duration and the incidence of abdominal obesity by sex *Model 1 adjusted for age, sex, education, marital status, smoking, drinking, BMI at baseline, diabetes, hypertension, physical function, depression status, automobile possession, and region; **In addition to covariates in model 1, daytime/nocturnal sleep duration and the interaction between daytime and nocturnal sleep duration were adjusted for in Model 2.
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