Relationship Between Body Mass Index and Perceived Insufficient Sleep Among U.S. Adults

An Analysis of 2008 BRFSS Data

Anne G Wheaton; Geraldine S Perry; Daniel P Chapman; Lela R McKnight-Eily; Letitia R Presley-Cantrell; Janet B Croft

BMC Public Health. 2011;11

Abstract and Introduction

Abstract

Background: Over the past 50 years, the average sleep duration for adults in the United States has decreased while the prevalence of obesity and associated outcomes has increased. The objective of this study was to determine whether perceived insufficient sleep was associated with body mass index (BMI) in a national sample.
Methods: We analyzed data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) survey (N = 384,541) in which respondents were asked, "During the past 30 days, for about how many days have you felt you did not get enough rest or sleep?" We divided respondents into six BMI categories and used multivariable linear regression and logistic regression analyses to assess the association between BMI categories and days of insufficient sleep after adjusting for sociodemographic variables, smoking, physical activity, and frequent mental distress.
Results: Adjusted mean days of insufficient sleep ranged from 7.9 (95% confidence interval [CI]: 7.8, 8.0) days for people of normal weight to 10.5 (95% CI: 10.2, 10.9) days for those in the highest weight category (BMI ≥ 40). Days of perceived insufficient sleep followed a linear trend across BMI categories. The likelihood of reporting ≥14 days of insufficient sleep in the previous 30 days was higher for respondents in the highest weight category than for those who were normal weight (34.9% vs. 25.2%; adjusted odds ratio = 1.7 (95% CI: 1.5, 1.8]).
Conclusion: Among U.S. adults, days of insufficient rest or sleep strongly correlated with BMI. Sleep sufficiency should be an important consideration in the assessment of the health of overweight and obese people and should be considered by developers of weight-reduction programs.

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Table 1. Characteristics of respondents to perceived insufficient sleep question: Behavioral Risk Factor Surveillance System Survey, 2008.
Characteristic	n¹	%²
Total	384,541	100.0
Sex
Men	150,407	50.5
Women	234,134	49.5
Race/Ethnicity
White, non-Hispanic	305,289	68.9
Black, non-Hispanic	29,745	9.8
Hispanic	25,255	14.5
Other/multiracial³	21,051	6.8
Age
18–24	12,794	12.2
25–34	35,636	17.9
35–44	57,994	19.1
45–54	79,775	19.3
55–64	82,897	14.5
65+	115,445	17.0
Education Level
<High school diploma	36,522	10.9
High school diploma or GED	115,468	28.7
Some college	102,219	26.7
College graduate	129,838	33.8
Smoker
Current	65,956	18.7
Former	114,800	24.6
Never	202,463	56.6
Physical Activity in Past Month
No	104,238	25.0
Yes	279,924	75.0
Frequent Mental Distress ⁴
No	340,634	89.7
Yes	39,088	10.4
BMI Category ⁵
Underweight	6,253	1.8
Normal weight	131,009	35.1
Overweight	141,082	36.4
Obese class I	67,084	17.1
Obese class II	24,609	6.1
Obese class III	14,504	3.5
Days of Insufficient Sleep
0 days	137,781	30.6
1–13 days	148,476	41.5
14–29 days	57,931	16.9
30 days	40,353	11.1

¹ Unweighted n's. Categories may not sum to survey total because of missing responses.
² Weighted percentage.
³ Asian, Native Hawaiian or Other Pacific Islander, American Indian/Alaska Native, or multiracial.
⁴ Frequent mental distress: Mental health, including stress, depression, and problems with emotions, was not good for ≥14 days in past 30 days.
⁵ BMI categories: underweight (BMI < 18.5), normal weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30), obese class I (30 ≤ BMI < 35), obese class II (35 ≤ BMI < 40), obese class III (BMI ≥ 40).

Table 2. Perceived insufficient sleep among U.S. adults, aged ≥18 years, by selected characteristics: BRFSS, 2008.
	n¹	Number of Days (in Past 30 Days)		≥14 Days of Insufficient Sleep in Past 30 Days
	n¹	Mean²	(95% CI)	%²	(95% CI)	OR²	(95% CI)
Total	384,541	8.6	(8.5–8.6)	27.9	(27.6–28.2)
Sex
Men	150,407	8.0	(7.9–8.1)	25.9	(25.4–26.3)	Referent
Women	234,134	9.1	(9.0–9.2)	29.9	(29.5–30.4)	1.3	(1.2–1.3)
Race/Ethnicity
White, non-Hispanic	305,289	8.9	(8.9–9.0)	29.2	(28.8–29.5)	Referent
Black, non-Hispanic	29,745	8.5	(8.3–8.8)	27.3	(26.3–28.4)	0.9	(0.9–1.0)
Hispanic	25,255	6.9	(6.6–7.1)	22.3	(21.3–23.3)	0.7	(0.6–0.7)
Other/multiracial³	21,051	8.4	(8.1–8.7)	28.2	(26.9–29.5)	0.9	(0.9–1.0)
Age
18–24	12,794	10.2	(9.9–10.5)	33.9	(32.5–35.4)	3.1	(2.8–3.3)
25–34	35,636	10.5	(10.3–10.7)	35.1	(34.2–36.0)	3.2	(3.1–3.4)
35–44	57,994	9.7	(9.6–9.9)	32.1	(31.4–32.8)	2.8	(2.7–2.9)
45–54	79,775	8.7	(8.6–8.8)	27.9	(27.3–28.4)	2.3	(2.2–2.4)
55–64	82,897	7.2	(7.1–7.3)	23.0	(22.5–23.6)	1.7	(1.6–1.8)
65+	115,445	5.0	(4.9–5.1)	15.4	(15.0–15.8)	Referent
Education Level
<High school diploma	36,522	8.3	(8.1–8.6)	27.3	(26.2–28.4)	1.0	(0.9–1.1)
High school diploma or GED	115,468	8.4	(8.2–8.5)	27.2	(26.7–27.8)	1.0	(0.9–1.0)
Some college	102,219	8.8	(8.7–9.0)	29.1	(28.6–29.7)	1.1	(1.0–1.1)
College graduate	129,838	8.6	(8.5–8.7)	27.5	(27.0–28.1)	Referent
Smoker
Current	65,956	9.9	(9.7–10.0)	32.7	(31.9–33.4)	1.4	(1.4–1.5)
Former	114,800	8.6	(8.5–8.7)	28.3	(27.7–28.9)	1.1	(1.1–1.2)
Never	202,463	8.1	(8.0–8.2)	26.0	(25.6–26.4)	Referent
Physical Activity in Past Month
No	104,238	9.6	(9.5–9.8)	32.2	(31.6–32.8)	1.4	(1.3–1.4)
Yes	279,924	8.2	(8.1–8.3)	26.4	(26.1–26.8)	Referent
Frequent Mental Distress ⁴
No	340,634	7.8	(7.7–7.8)	24.5	(24.2–24.8)	Referent
Yes	39,088	15.6	(15.4–15.8)	55.9	(54.8–56.9)	4.2	(4.0–4.4)
BMI Category ⁵
Underweight	6,253	8.6	(8.0–9.2)	27.6	(25.2–30.0)	1.1	(1.0–1.3)
Normal weight	131,009	7.9	(7.8–8.0)	25.2	(24.7–25.7)	Referent
Overweight	141,082	8.5	(8.4–8.6)	27.6	(27.1–28.1)	1.1	(1.1–1.2)
Obese class I	67,084	9.3	(9.1–9.5)	30.8	(30.1–31.6)	1.4	(1.3–1.4)
Obese class II	24,609	9.7	(9.4–10.0)	32.3	(31.1–33.5)	1.5	(1.4–1.6)
Obese class III	14,504	10.5	(10.2–10.9)	34.9	(33.3–36.5)	1.7	(1.5–1.8)

¹ Unweighted n's.
² Weighted means, proportions, and odds ratios adjusted for all other variables in the table.
³ Asian, Native Hawaiian or Other Pacific Islander, American Indian/Alaska Native, or multiracial.
⁴ Frequent mental distress: Mental health, including stress, depression, and problems with emotions, was not good for ≥14 days in past 30 days.
⁵ Underweight (BMI < 18.5), normal weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30), obese class I (30 ≤ BMI < 35), obese class II (35 ≤ BMI < 40), obese class III (BMI ≥ 40).

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Relationship Between Body Mass Index and Perceived Insufficient Sleep Among U.S. Adults

An Analysis of 2008 BRFSS Data

Abstract and Introduction

Abstract

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Tables

References

Authors and Disclosures

Authors and Disclosures

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