The association between self-reported sleep quality and overweight in a Chinese population

Sleep quality and obesity are associated with type 2 diabetes, hypertension, and metabolic syndrome. However, there is limited research on the association between sleep quality and obesity, and thus the aim of this study is to investigate this relationship in a Chinese population.

Subjects were recruited from the Prevention Health Center of National Cheng Kung University Hospital. Anthropometric data and metabolic parameters were measured. Being overweight or obese was defined according to the recommendations of the Department of Health in Taiwan. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI).

Of the total 2,803 subjects, 1,059 were classified as normal weight, 1,127 were overweight, and 617 were obese. The global PSQI score were 6.30 ± 2.56, 6.61 ± 2.96, and 7.02 ± 2.95 in subjects who were normal weight, overweight, and obese, respectively (test for trend, P < 0.001). Of the variables tested in the multivariate linear regression model, female gender, being overweight, obesity, sleep duration, and alcohol drinking were significantly associated with global PSQI scores, and in the multivariate logistic regression model, female gender, being overweight, obesity, and sleep duration were independent predictors of poor sleepers after controlling for age, gender, BMI or different weight statuses, sleep duration, alcohol drinking, smoking, habitual exercise, hypertension, newly diagnosed diabetes, total cholesterol, high-density lipoprotein, triglyceride, estimated glomerular filtration rate, and alanine aminotransferase.

In conclusion, female gender, being overweight, obesity, and sleep duration were associated with poor sleep quality independent of cardiometabolic risk factors. In clinical practice, subjects who are obese, or even only overweight, should be evaluated for the presence of sleep disturbance.