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 

In This Article

1. Background

Over the past 50 years, the prevalence of obesity among U.S. adults has nearly tripled from about 13% in 1960–1962 to 34% in 2007–2008.[1,2] Obesity is a major risk factor for many chronic diseases including type 2 diabetes, cardiovascular diseases, cancer, and obstructive sleep apnea.[3–6] As the prevalence of obesity increased, the percentage of U.S. adults who reported an average of ≤6 hours of sleep per day also increased, from 22–23% in 1985 to nearly 30% in 2005–2007.[7,8] Results from a recent analysis of Behavioral Risk Factor Surveillance System (BRFSS) data from 2008 showed that only 30% of U.S. adults felt they had received adequate sleep every night in the previous month and that more than 10% felt they had received inadequate sleep every night.[9] Causes of sleep loss other than sleep disorders include lifestyle and occupational factors.[10] Numerous cross-sectional studies have found an inverse relationship between sleep duration and body mass index (BMI);[11,12] however, others have found a U-shaped association, with a lower BMI among people averaging 7–8 hours of sleep and a higher BMI among those with shorter and longer sleep durations.[13–15] These studies relied on subjective reports of sleep duration, but the CARDIA Sleep Study, which used an objective measure (wrist actigraphy), also found that BMI was inversely associated with sleep duration, as well as with sleep fragmentation.[16] Recent laboratory-based studies have demonstrated that chronic sleep restriction may contribute to obesity by decreasing levels of leptin and increasing levels of ghrelin, hormones involved in satiety and hunger-promotion, respectively.[17,18]

Results of a previous analysis of 2002 BRFSS data from 18 states concerning perceived insufficient rest or sleep showed that the prevalence of obesity (defined as a BMI ≥ 30) was higher among respondents who reported ≥14 days of insufficient sleep in the previous 30 days than among those who reported <14 days.[19] To confirm and expand on these previous findings showing a positive association between multiple levels of BMI and perceived insufficient rest or sleep in a national sample, we analyzed 2008 BRFSS data and adjusted results for sociodemographic variables, as well as for smoking, physical activity, and frequent mental distress.


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