American Journal of Epidemiology Advance Access originally published online on August 3, 2009
American Journal of Epidemiology 2009 170(7):805-813; doi:10.1093/aje/kwp230
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ORIGINAL CONTRIBUTIONS |
Cross-sectional and Longitudinal Associations Between Objectively Measured Sleep Duration and Body Mass Index
The CARDIA Sleep Study
Correspondence to Dr. Diane S. Lauderdale, Department of Health Studies, University of Chicago, 5801 South Ellis Avenue, Chicago, IL 60637 (e-mail: lauderdale{at}health.bsd.uchicago.edu).
Received for publication September 16, 2008. Accepted for publication March 27, 2009.
Numerous studies have found an association between shorter sleep duration and higher body mass index (BMI) in adults. Most previous studies have been cross-sectional and relied on self-reported sleep duration, which may not be very accurate. In the Coronary Artery Risk Development in Young Adults (CARDIA) Sleep Study (2000–2006), the authors examine whether objectively measured sleep is associated with BMI and change in BMI. They use several nights of wrist actigraphy to measure sleep among participants in an ongoing cohort of middle-aged adults. By use of linear regression, the authors examine whether average sleep duration or fragmentation is associated with BMI and 5-year change in BMI, adjusting for confounders. Among 612 participants, sleep duration averaged 6.1 hours and was grouped into 4 categories. Both shorter sleep and greater fragmentation were strongly associated with higher BMI in unadjusted cross-sectional analysis. After adjustment, BMI decreased by 0.78 kg/m2 (95% confidence interval: –1.6, –0.002) for each increasing sleep category. The association was very strong in persons who reported snoring and weak in those who did not. There were no longitudinal associations between sleep measurements and change in BMI. The authors confirmed a cross-sectional association between sleep duration and BMI using objective sleep measures, but they did not find that sleep predicted change in BMI. The mechanism underlying the cross-sectional association is not clear.
body mass index; cohort studies; sleep; snoring
Abbreviations: BMI, body mass index; CARDIA, Coronary Artery Risk Development in Young Adults; CI, confidence interval; SD, standard deviation
Editor's note: An invited commentary on this article appears on page 814, and the authors’ response is published on page 817.
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Related articles in Am. J. Epidemiol.:
- Invited Commentary: Understanding the Role of Sleep
- Sanjay R. Patel
Am. J. Epidemiol. 2009 170: 814-816.[Abstract] [FREE Full Text] - Lauderdale et al. Respond to "Understanding the Role of Sleep"
- Diane S. Lauderdale, Kristen L. Knutson, Paul J. Rathouz, Lijing L. Yan, Stephen B. Hulley, and Kiang Liu
Am. J. Epidemiol. 2009 170: 817-818.[Extract] [FREE Full Text]
This article has been cited by other articles:
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  L. L. Magee and L. E. Hale Re: "Cross-Sectional and Longitudinal Associations Between Objectively Measured Sleep Duration and Body Mass Index: The Cardia Sleep Study" Am. J. Epidemiol., February 8, 2010; (2010) kwq018v1. [Full Text] [PDF]
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D. S. Lauderdale, K. L. Knutson, P. J. Rathouz, L. L. Yan, S. B. Hulley, and K. Liu The Authors Reply Am. J. Epidemiol., February 8, 2010; (2010) kwq019v1. [Full Text] [PDF]
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S. R. Patel Invited Commentary: Understanding the Role of Sleep Am. J. Epidemiol., October 1, 2009; 170(7): 814 - 816. [Abstract] [Full Text] [PDF]
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D. S. Lauderdale, K. L. Knutson, P. J. Rathouz, L. L. Yan, S. B. Hulley, and K. Liu Lauderdale et al. Respond to "Understanding the Role of Sleep" Am. J. Epidemiol., October 1, 2009; 170(7): 817 - 818. [Full Text] [PDF]
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