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

Disclosures

BMC Public Health. 2011;11 

In This Article

2. Methods

The BRFSS collects data through annual state-based telephone surveys of non-institutionalized U.S. civilians aged ≥18 years. The surveys are conducted in all 50 states, the District of Columbia, and three U.S. territories (Guam, Puerto Rico, and the Virgin Islands). As the BRFSS is a public-use dataset, this research was exempt from review by an institutional review board. The core questionnaire of the 2008 BRFSS survey, which was administered to all survey participants, included the following question, "During the past 30 days, for about how many days have you felt you did not get enough rest or sleep?"

Survey participants' BMI was calculated from their self-reported weight and height (weight [kg]/height [m2]); and their BMI-based weight classification was determined on the basis of National Heart, Lung, and Blood Institute criteria: underweight (BMI < 18.5), normal weight (BMI = 18.5–24.9), overweight (BMI = 25.0–29.9), obese class I (BMI = 30.0–34.9), obese class II (BMI = 35.0–39.9), and obese class III (BMI ≥ 40).[20] Female survey participants were also asked whether they were currently pregnant.

In our analysis, we assessed the extent to which two measures of sleep (mean number of days of insufficient sleep and prevalence of ≥14 days of insufficient sleep) were associated with BMI category. We also assessed the extent to which these measures were associated with sex, age in years (18–24, 25–34, 35–44, 45–54, 55–64, and ≥65), race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and non-Hispanic multiracial/other), education level (less than high school graduate, high school graduate or GED recipient, some college, and college graduate), smoking status (current, former, and never), recent physical activity (yes or no), and frequent mental distress (yes or no). Current smoking was defined as having smoked at least 100 cigarettes in one's lifetime and now smoking on at least "some days." Former smoking was defined as having smoked at least 100 cigarettes in one's lifetime but not currently smoking. Never smoking was defined as not having smoked at least 100 cigarettes in one's lifetime. Any recent physical activity was defined on the basis of survey participants' response to the question, "During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?" Frequent mental distress was defined on the basis of participants' response to the question, "Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?" A response of ≥14 days in the previous 30 days indicated frequent mental distress.

We conducted all analyses using SAS-callable SUDAAN (version 10.0.0, Research Triangle Park, NC) to account for the complex sampling design of the BRFSS. We used multivariate linear regression analyses to calculate mean days of insufficient rest or sleep adjusted for sex, race/ethnicity, age, education level, smoking status, recent physical activity, and frequent mental distress. We used multivariate logistic regression analyses to calculate the proportion of respondents reporting ≥14 days of insufficient sleep during the previous 30 days by BMI category and odds ratios (ORs) for receiving ≥14 days of insufficient sleep by BMI category. All ORs were adjusted for sex, race/ethnicity, age, education level, smoking status, recent physical activity, and frequent mental distress.

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