The Sleep-Obesity Nexus: Assessment of Multiple Sleep Dimensions and Weight Status Among Victorian Primary School Children

PURPOSE: To examine the association between sleep and weight status across multiple dimensions of sleep (duration, efficiency, quality and timing) and assess the cumulative influence of these dimensions on the overall sleep-obesity association. PARTICIPANTS AND METHODS: Cross-sectional data from 2253 students aged 8.8 to 13.5 years participating in two monitoring studies across regional Victoria was analyzed. Students were invited to have measures of height and weight taken and to complete a self-report electronic questionnaire on demographic characteristics and health behaviors. Logistic regression models were used to assess association between sleep dimensions and BMI z-scores. RESULTS: Beyond sleep duration, poor perceived sleep quality, delayed sleep initiation, later bed times and sleep-wake timing, all significantly increased the odds of overweight/obesity (OR 1.47, 95% CI: 1.07–2.01; OR 1.25, 95% CI: 1.02–1.55; and OR 1.70. 95% CI: 1.28–2.28, respectively). Additionally, a cumulative effect of having multiple poorly scored sleep dimensions was found, where four or more poorly scored sleep dimensions more than doubled the odds of overweight/obesity among children (OR 2.25, 95% CI: 1.41–3.58). CONCLUSION: This study highlights the importance of measuring and considering multiple dimensions of sleep, along with the individual and additive influence of the sleep dimension on the sleep-obesity nexus.