Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

The association between sleep duration and obesity in older adults

Abstract

Background:

Reduced sleep has been reported to predict obesity in children and young adults. However, studies based on self-report have been unable to identify an association in older populations. In this study, the cross-sectional associations between sleep duration measured objectively and measures of weight and body composition were assessed in two cohorts of older adults.

Methods:

Wrist actigraphy was performed for a mean (s.d.) of 5.2 (0.9) nights in 3055 men (age: 67–96 years) participating in the Osteoporotic Fractures in Men Study (MrOS) and 4.1 (0.8) nights in 3052 women (age: 70–99 years) participating in the Study of Osteoporotic Fractures (SOF). A subgroup of 2862 men and 455 women also underwent polysomnography to measure sleep apnea severity.

Results:

Compared to those sleeping an average of 7–8 h per night, and after adjusting for multiple risk factors and medical conditions, a sleep duration of less than 5 h was associated with a body mass index (BMI) that was on average 2.5 kg/m2 (95% confidence interval (CI): 2.0–2.9) greater in men and 1.8 kg/m2 (95% CI: 1.1–2.4) greater in women. The odds of obesity (BMI 30 kg/m2) was 3.7-fold greater (95% CI: 2.7–5.0) in men and 2.3-fold greater in women (95% CI: 1.6–3.1) who slept less than 5 h. Short sleep was also associated with central body fat distribution and increased percent body fat. These associations persisted after adjusting for sleep apnea, insomnia and daytime sleepiness.

Conclusions:

In older men and women, actigraphy-ascertained reduced sleep durations are strongly associated with greater adiposity.

This is a preview of subscription content

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Figure 1
Figure 2
Figure 3

References

  1. Flegal KM, Carroll MD, Ogden CL, Johnson CL . Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002; 288: 1723–1727.

    Article  Google Scholar 

  2. National Sleep Foundation. 2005 Sleep in America Poll. National Sleep Foundation: Washington, 2005.

  3. Hasler G, Buysse DJ, Klaghofer R, Gamma A, Ajdacic V, Eich D et al. The association between short sleep duration and obesity in young adults: a 13-year prospective study. Sleep 2004; 27: 661–666.

    Article  Google Scholar 

  4. Agras WS, Hammer LD, McNicholas F, Kraemer HC . Risk factors for childhood overweight: a prospective study from birth to 9.5 years. J Pediatr 2004; 145: 20–25.

    Article  Google Scholar 

  5. Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, Ness A, Rogers I et al. Early life risk factors for obesity in childhood: cohort study. BMJ 2005; 330: 1357.

    Article  Google Scholar 

  6. Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep 2008; 31: 619–626.

    Article  Google Scholar 

  7. Patel SR, Hu FB . Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring) 2008; 16: 643–653.

    Article  Google Scholar 

  8. Marshall NS, Glozier N, Grunstein RR . Is sleep duration related to obesity? A critical review of the epidemiological evidence. Sleep Med Rev 2008; 12: 289–298.

    Article  Google Scholar 

  9. Taheri S, Thomas GN . Is sleep duration associated with obesity—Where do U stand? Sleep Med Rev 2008; 12: 299–302.

    Article  Google Scholar 

  10. Gangwisch JE, Malaspina D, Boden-Albala B, Heymsfield SB . Inadequate sleep as a risk factor for obesity: analyses of the NHANES I. Sleep 2005; 28: 1289–1296.

    Article  Google Scholar 

  11. Ohayon MM . Interactions between sleep normative data and sociocultural characteristics in the elderly. J Psychosom Res 2004; 56: 479–486.

    Article  Google Scholar 

  12. van den Berg JF, Knvistingh Neven A, Tulen JH, Hofman A, Witteman JC, Miedema HM et al. Actigraphic sleep duration and fragmentation are related to obesity in the elderly: the Rotterdam Study. Int J Obes (Lond) 2008; 32: 1083–1090.

    CAS  Article  Google Scholar 

  13. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM . Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006; 295: 1549–1555.

    CAS  Article  Google Scholar 

  14. Cummings SR, Black DM, Nevitt MC, Browner WS, Cauley JA, Genant HK et al. Appendicular bone density and age predict hip fracture in women. The Study of Osteoporotic Fractures Research Group. JAMA 1990; 263: 665–668.

    CAS  Article  Google Scholar 

  15. Blank JB, Cawthon PM, Carrion-Petersen ML, Harper L, Johnson JP, Mitson E et al. Overview of recruitment for the osteoporotic fractures in men study (MrOS). Contemp Clin Trials 2005; 26: 557–568.

    Article  Google Scholar 

  16. Orwoll E, Blank JB, Barrett-Connor E, Cauley J, Cummings S, Ensrud K et al. Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study—a large observational study of the determinants of fracture in older men. Contemp Clin Trials 2005; 26: 569–585.

    Article  Google Scholar 

  17. Blackwell T, Redline S, Ancoli-Israel S, Schneider JL, Surovec S, Johnson NL et al. Comparison of sleep parameters from actigraphy and polysomnography in older women: the SOF study. Sleep 2008; 31: 283–291.

    Article  Google Scholar 

  18. Blackwell T, Redline S, Ancoli-Israel S, Stone K . Comparison of total sleep time from actigraphy and polysomnography in older men: the MrOS Sleep Study. Sleep 2007; 30: A346–A347.

    Google Scholar 

  19. Ambulatory Monitoring, Inc. Action-W User's Guide, Version 2.0. Ambulatory Monitoring Inc.: Ardsley, NY.

  20. Girardin JL, Kripke DF, Mason WJ, Elliot JA, Youngstedt SD . Sleep estimation from wrist movement quantified by different actigraphic modalities. J Neurosci Methods 2001; 105: 185–191.

    Article  Google Scholar 

  21. Blackwell T, Ancoli-Israel S, Gehrman PR, Schneider JL, Pedula KL, Stone KL . Actigraphy scoring reliability in the study of osteoporotic fractures. Sleep 2005; 28: 1599–1605.

    Article  Google Scholar 

  22. Pahor M, Chrischilles EA, Guralnik JM, Brown SL, Wallace RB, Carbonin P . Drug data coding and analysis in epidemiologic studies. Eur J Epidemiol 1994; 10: 405–411.

    CAS  Article  Google Scholar 

  23. Sheikh JI, Yesavage JA . Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clin Gerontol 1986; 5: 165–173.

    Article  Google Scholar 

  24. Washburn RA, Smith KW, Jette AM, Janney CA . The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol 1993; 46: 153–162.

    CAS  Article  Google Scholar 

  25. Johns MW . A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991; 14: 540–545.

    CAS  Article  Google Scholar 

  26. Johns MW . Sensitivity and specificity of the multiple sleep latency test (MSLT), the maintenance of wakefulness test and the Epworth sleepiness scale: failure of the MSLT as a gold standard. J Sleep Res 2000; 9: 5–11.

    CAS  Article  Google Scholar 

  27. Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193–213.

    CAS  Article  Google Scholar 

  28. Rechtschaffen A, Kales A . A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. US Government Printing Office: Washington, DC, 1968.

    Google Scholar 

  29. American Academy of Sleep Medicine. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep 1999; 22: 667–689.

  30. Ford DE, Kamerow DB . Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA 1989; 262: 1479–1484.

    CAS  Article  Google Scholar 

  31. Maggi S, Langlois JA, Minicuci N, Grigoletto F, Pavan M, Foley DJ et al. Sleep complaints in community-dwelling older persons: prevalence, associated factors, and reported causes. J Am Geriatr Soc 1998; 46: 161–168.

    CAS  Article  Google Scholar 

  32. Carey VJ, Walters EE, Colditz GA, Solomon CG, Willett WC, Rosner BA et al. Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women. The Nurses’ Health Study. Am J Epidemiol 1997; 145: 614–619.

    CAS  Article  Google Scholar 

  33. Cox BD, Whichelow MJ, Prevost AT . The development of cardiovascular disease in relation to anthropometric indices and hypertension in British adults. Int J Obes Relat Metab Disord 1998; 22: 966–973.

    CAS  Article  Google Scholar 

  34. Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ et al. Abdominal adiposity and coronary heart disease in women. JAMA 1998; 280: 1843–1848.

    CAS  Article  Google Scholar 

  35. Cappuccio FP, Stranges S, Kandala NB, Miller MA, Taggart FM, Kumari M et al. Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II Study. Hypertension 2007; 50: 693–700.

    CAS  Article  Google Scholar 

  36. Meisinger C, Heier M, Lowel H, Schneider A, Doring A . Sleep duration and sleep complaints and risk of myocardial infarction in middle-aged men and women from the general population: the MONICA/KORA Augsburg cohort study. Sleep 2007; 30: 1121–1127.

    Article  Google Scholar 

  37. Bliwise DL, Young TB . The parable of parabola: what the U-shaped curve can and cannot tell us about sleep. Sleep 2007; 30: 1614–1615.

    Article  Google Scholar 

  38. Lauderdale DS, Knutson KL, Yan LL, Rathouz PJ, Hulley SB, Sidney S et al. Objectively measured sleep characteristics among early-middle-aged adults: the CARDIA study. Am J Epidemiol 2006; 164: 5–16.

    Article  Google Scholar 

  39. Silva GE, Goodwin JL, Sherrill DL, Arnold JL, Bootzin RR, Smith T et al. Relationship between reported and measured sleep times: the sleep heart health study (SHHS). J Clin Sleep Med 2007; 3: 622–630.

    PubMed  PubMed Central  Google Scholar 

  40. Ancoli-Israel S, Kripke DF, Klauber MR, Mason WJ, Fell R, Kaplan O . Sleep-disordered breathing in community-dwelling elderly. Sleep 1991; 14: 486–495.

    CAS  Article  Google Scholar 

  41. Young T, Peppard PE, Taheri S . Excess weight and sleep-disordered breathing. J Appl Physiol 2005; 99: 1592–1599.

    Article  Google Scholar 

  42. Gottlieb DJ, Redline S, Nieto FJ, Baldwin CM, Newman AB, Resnick HE et al. Association of usual sleep duration with hypertension: the Sleep Heart Health Study. Sleep 2006; 29: 1009–1014.

    Article  Google Scholar 

  43. Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB . Association between reduced sleep and weight gain in women. Am J Epidemiol 2006; 164: 947–954.

    Article  Google Scholar 

  44. Vorona RD, Winn MP, Babineau TW, Eng BP, Feldman HR, Ware JC . Overweight and obese patients in a primary care population report less sleep than patients with a normal body mass index. Arch Intern Med 2005; 165: 25–30.

    Article  Google Scholar 

  45. Ohayon MM, Vecchierini MF . Normative sleep data, cognitive function and daily living activities in older adults in the community. Sleep 2005; 28: 981–989.

    Article  Google Scholar 

  46. Spiegel K, Tasali E, Penev P, Van Cauter E . Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004; 141: 846–850.

    Article  Google Scholar 

Download references

Acknowledgements

In addition to the support below, this study was supported by National Institutes of Health Grant HL081385. The Osteoporotic Fractures in Men (MrOS) Study was supported by National Institutes of Health funding. The following institutes provided support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR) and NIH Roadmap for Medical Research under the following Grant numbers: AR045580, AR045614, AR045632, AR045647, AR045654, AR045583, AG018197, AG027810 and RR024140. The National Heart, Lung, and Blood Institute (NHLBI) provided funding for the MrOS Sleep ancillary study ‘Outcomes of Sleep Disorders in Older Men’ under the following Grant numbers: HL071194, HL070848, HL070847, HL070842, HL070841, HL070837, HL070838 and HL070839. The Study of Osteoporotic Fractures (SOF) was supported by National Institutes of Health funding. The following institutes provided support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the National Institute on Aging (NIA) under the following Grant numbers: AG005407, AR035582, AG005394, AR035584, AR035583, AG027576, AG005394, AG027574 and AG026720.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to S R Patel.

Additional information

Disclosures

Drs Patel, Redline, Ancoli-Israel, Cauley, Hillier, Lewis, Stefanick, Taylor, and Yaffe and Ms Blackwell have no financial disclosures to report. Dr Orwoll has received honoraria from Merck and is a paid consultant for Merck, Eli Lilly & Co., and Servier. He has active research support from Amgen, Eli Lily & Co. and Solvay Pharmaceuticals and has had previous research support from Pfizer, Zelos Therapeutics and Imaging Therapeutics. Dr Stone is a paid consultant for Sepracor and a paid speaker for Sanofi-Aventis.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Patel, S., Blackwell, T., Redline, S. et al. The association between sleep duration and obesity in older adults. Int J Obes 32, 1825–1834 (2008). https://doi.org/10.1038/ijo.2008.198

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2008.198

Keywords

  • sleep duration
  • sleep deprivation
  • central obesity
  • geriatrics
  • insomnia
  • sleepiness

Further reading

Search

Quick links