Associations between Body Mass Index, Sleep Duration, and Reported Snoring and Sleepiness Symptoms, By Age Stratification


  •   David W. Lin

  •   Weijie V. Lin


To further clarify the associations between sleep and body mass index (BMI) using the most recent dataset from the National Health and Nutrition Examination Survey (NHANES). Our study is notable for the inclusion of analyses with age subpopulations and subjective sleep symptoms. Cross-sectional study was performed using the NHANES 2017-18 dataset. Weighted multivariate regressions were utilized. NHANES is a standardized survey conducted biennially in the United States, for a sample population which is weighted to represent national demographics. 6161 participants met inclusion criteria. Measurements were collected via NHANES protocol, with objective measurements collected by trained technicians and self-reported measurements collected via questionnaire. Our results corroborate a roughly U-shaped relationship of sleep duration with BMI, varying with age. Greatest magnitudes were observed in a bimodal age ranges of 18-30 and 61-75, with decreases in BMI of 0.248 and 0.385 associated with each marginal hour of sleep. Our secondary analysis with daytime sleepiness and snoring have a significant association with BMI. Snoring symptoms showed a decreasing magnitude of association with BMI as age increases; for ages 18-30, snoring at least once a week correlated with an increase in BMI of 3.571, while for ages 61-75, this correlated with an increase of 1.619. Our study adds to existing literature on the relationship of sleep and BMI. Age stratification methods were used to further clarify associations. Subjective sleep symptoms were used in a secondary analysis to identify clinical screening questions for adverse effects of sleep on BMI.

Keywords: Sleep disorder, Body-mass index, Age stratification, Weighted linear regression


J. Theorell-Haglow, E. Lindberg, "Sleep Duration and Obesity in Adults: What Are the Connections?" Curr Obes Rep., vol. 5, no. 3, pp. 333-343, 2016.

J. P. Chaput, T. J. Saunders, and V. Carson , "Interactions between sleep, movement and other non-movement behaviours in the pathogenesis of childhood obesity," Obes Rev., vol. 18 Suppl 1:7-14, 2017.

K. H. Cho, E. H. Cho, J. Hur J, and D. Shin, "Association of Sleep Duration and Obesity According to Gender and Age in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey 2007-2015," J Korean Med Sci., vol. 33, no. 53:e345, 2018.

B. L. Elder, E. M. Ammar, and D. Pile, "Sleep Duration, Activity Levels, and Measures of Obesity in Adults," Public Health Nurs., vol. 33, no. 3, pp. 200-205, 2016.

A. Gohil A and T. S. Hannon, "Poor Sleep and Obesity: Concurrent Epidemics in Adolescent Youth," Front Endocrinol (Lausanne), vol. 9, no. 364, 2018.

J. E. Gangwisch, D. Malaspina, B. Boden-Albala, and S. B. Heymsfield, "Inadequate sleep as a risk factor for obesity: analyses of the NHANES I," Sleep., vol. 28, no. 10, pp. 1289-1296, 2005.

Q. Xiao, F. Gu, N. Caporaso, and C. E. Matthews, "Relationship between sleep characteristics and measures of body size and composition in a nationally-representative sample," BMC Obes., vol. 3, no. 48, 2016.

A. Culebras and S. Anwar, "Sleep Apnea Is a Risk Factor for Stroke and Vascular Dementia," Curr Neurol Neurosci Rep., vol. 18, no. 8, p. 53, 2018.

J. E. Gangwisch, S. B. Heymsfield, B. Boden-Albala, et al, "Sleep duration as a risk factor for diabetes incidence in a large U.S. sample," Sleep, vol. 30, no. 12, pp. 1667-1673, 2007.

M. A. Grandner, S. Chakravorty, M. L. Perlis, L. Oliver, and I. Gurubhagavatula, "Habitual sleep duration associated with self-reported and objectively determined cardiometabolic risk factors," Sleep Med., vol. 15, no. 1, pp. 42-50, 2014.

S. J. Thomas and D. Calhoun, "Sleep, insomnia, and hypertension: current findings and future directions," J Am Soc Hypertens, vol. 11, no. 2, pp. 122-129, 2017.

N. Covassin and P. Singh, "Sleep Duration and Cardiovascular Disease Risk: Epidemiologic and Experimental Evidence," Sleep Med Clin., vol. 11, no. 1, pp. 81-89, 2016.

E. Tobaldini, G. Costantino, M. Solbiati, et al, "Sleep, sleep deprivation, autonomic nervous system and cardiovascular diseases," Neurosci Biobehav Rev., vol.74(Pt B), pp. 321-329, 2017.

S. M. Bertisch, B. D. Pollock, M. A. Mittleman, et al, "Insomnia with objective short sleep duration and risk of incident cardiovascular disease and all-cause mortality: Sleep Heart Health Study," Sleep, vol. 41, no. 6, 2018.

G. Muscogiuri, L. Barrea, G. Annunziata, et al, "Obesity and sleep disturbance: the chicken or the egg?" Crit Rev Food Sci Nutr., vol. 59, no. 13, pp. 2158-2165, 2019.

A. A. Prather, C. W. Leung, N. E. Adler, L. Ritchie, B. Laraia, and E. S. Epel, "Short and sweet: Associations between self-reported sleep duration and sugar-sweetened beverage consumption among adults in the United States," Sleep Health, vol. 2, no. 4, pp. 272-276, 2016.

M. P. St-Onge, "Sleep-obesity relation: underlying mechanisms and consequences for treatment," Obes Rev., vol. 18 Suppl 1, pp. 34-39, 2017.

L. A. Vezina-Im, T. A. Nicklas, and T. Baranowski, "Associations Among Sleep, Body Mass Index, Waist Circumference, and Risk of Type 2 Diabetes Among U.S. Childbearing-Age Women: National Health and Nutrition Examination Survey," J Womens Health (Larchmt), vol. 27, no. 11, pp. 1400-1407, 2018.

Y. Wang, H. Mei, Y. R. Jiang, et al, "Relationship between Duration of Sleep and Hypertension in Adults: A Meta-Analysis," J Clin Sleep Med., vol. 11, no. 9, pp. 1047-1056, 2015.

R. P. Ogilvie and S. R. Patel, "The epidemiology of sleep and obesity," Sleep Health, vol. 3, no. 5, pp. 383-388, 2017.

M. A. Grandner, E. A. Schopfer, M. Sands-Lincoln, N. Jackson, and A. Malhotra, "Relationship between sleep duration and body mass index depends on age," Obesity (Silver Spring), vol. 23, no. 12, pp. 2491-2498, 2015.

M. A. Grandner, "Sleep, Health, and Society," Sleep Med Clin., vol. 12, no. 1, pp. 1-22, 2017.

TC CJ Chen, M. K. Riddles, L. K. Mohadjer, and T. H. I. Fakhouri, "National Health and Nutrition Examination Survey, 2015−2018: Sample design and estimation procedures," In: Statistics NCfH, ed. Vital Health Stat, 2020.

M. Juda, C. Vetter, and T. Roenneberg, "The Munich ChronoType Questionnaire for Shift-Workers (MCTQShift)," J Biol Rhythms, vol. 28, no. 2, pp. 130-140, 2013.

S. Taheri, L. Lin, D. Austin, T. Young, and E. Mignot, "Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index," PLoS Med., vol. 1, no. 3:e62, 2004.


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How to Cite
Lin, D.W. and Lin, W.V. 2020. Associations between Body Mass Index, Sleep Duration, and Reported Snoring and Sleepiness Symptoms, By Age Stratification. European Journal of Engineering and Technology Research. 5, 10 (Oct. 2020), 1263-1268. DOI: