Unhealthy Sleep Patterns, Duration Linked With Obesity

Unhealthy sleep patterns and shorter sleep duration both correlated with obesity occurrence in American adults, suggesting that interventions to promote healthy sleep habits could help reduce the risk of obesity, according to a study published in BMC Public Health.¹ 

Obesity, which is considered a major public health issue, has more than doubled since 1990 and affected 890 million people globally in 2022.² The authors of the current study noted that increasing evidence suggests a link between sleep duration and sleep quality with obesity.¹ The new study aimed to create a sleep pattern score from the cumulative effect of sleep duration and quality, then evaluate their relationship with obesity occurrence.

Sleep duration and sleep pattern score were both independently associated with obesity occurrence, and there was a nonlinear relationship between obesity and sleep duration. | Image credit: Prostock-studio - stock.adobe.com

“Obesity poses significant risks to the human body, primarily by affecting metabolism and leading to a series of diseases such as insulin resistance, type 2 diabetes, nonalcoholic fatty liver disease, cardiovascular diseases, and cancer,” the authors wrote. “Therefore, it is increasingly important to take proactive measures to prevent and control obesity.”

The cross-sectional study used data from the National Health and Nutrition Survey, a national survey conducted by the National Center for Health Statistics, to collect data on sleep duration, excessive daytime sleepiness, and sleep problems. The investigators then calculated an overall sleep pattern score and stratified sleep patterns into 3 types: healthy, intermediate, and poor. Associations between sleep duration, sleep patterns, and obesity were determined through multivariable logistic regression models. Linearity tests explored the dose-response relationship between sleep duration and obesity, and further analyses evaluated the relationship’s stability across subgroups.

Data from 4540 participants were included in the study, and the average age was 50.5 years. Half of respondents (50%; n = 2271) were male, and 49.2% of respondents were non-Hispanic White (n = 2232). Participants with obesity were more likely to be female, non-Hispanic White, and less physically active. Hypertension, diabetes, and having never smoked or consumed alcohol were all more common among participants with obesity.

Sleep duration and sleep pattern score were both independently associated with obesity occurrence (OR, 0.91; 95% CI, 0.87-0.95; P < .001 and OR, 1.18; 95% CI, 1.1-1.27; P < .001, respectively). There was also a nonlinear relationship between obesity and sleep duration. The effects of sleep above and below a threshold of 9.73 hours were 0.89 (95% CI, 0.849-0.936) and 2.023 (95% CI, 1.113-3.677), respectively.

“Importantly, participants with obesity also exhibited poorer sleep conditions, with a higher prevalence of unhealthy sleep patterns and abnormal sleep duration,” the authors wrote. Using sleep pattern score as a continuous variable in a crude, unadjusted model, they found a significant correlation between the sleep pattern score and obesity risk (OR, 1.23; 95% CI, 1.15-1.32; P < .001). Adjustments did not significantly impact the results, the authors noted.

An analysis of the sleep score as a categorical variable showed that those with healthy sleep patterns had a lower likelihood of obesity compared with individuals who had poor sleep patterns (OR, 1.57; 95% CI, 1.34-1.84; P < .01). The risk of obesity was 41% higher among those with poor sleep patterns vs those with healthy sleep patterns in a model adjusting for age, sex, race and ethnicity, education level, marital status, household income, physical activity, hypertension, diabetes, smoking status, alcohol consumption, and energy intake.

“… An unhealthy sleep pattern was positively correlated with the occurrence of obesity, and the study indicated that the sleep pattern score had a higher predictive efficacy for obesity than using sleep duration alone. The establishment of sleep pattern scoring provided a more comprehensive predictive indicator for obesity,” the authors concluded. “So, interventions aimed at promoting healthy sleep habits and appropriate sleep duration may be important in reducing the risk of obesity.”

References

1. Xu Q, Lin Z, Chen Y, Huang M. Association between sleep duration and patterns and obesity: a cross-sectional study of the 2007–2018 National Health and Nutrition Examination Survey. BMC Public Health. Published online April 21, 2025. doi:10.1186/s12889-025-22433-9
2. Obesity and overweight. World Health Organization. March 1, 2024. Accessed April 21, 2025. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight