Is sleep duration related to obesity? A critical review of the epidemiological evidence
Abstract
1. Observational studies have implicated habitual sleep duration as a risk factor for mortality and morbidity. Part of this association might be mediated by obesity, which has also been associated with habitual sleep duration. These studies generate wide media attention because of the public's health concerns surrounding increasing obesity and the temporal association with the other modern "epidemic" of sleep loss. Some commentators have recommended public health interventions to control obesity via habitual sleep duration modification. We conducted a critical review of the available literature describing the relationship between habitual sleep duration and obesity in community-based studies in both adults and children, with particular emphasis on longitudinal studies and on studies with objective measures of habitual sleep duration. 2. Existing data have variable consistency. Only one study objectively measured sleep duration for more than one 24-h period. Cross-sectional and longitudinal studies in adults often demonstrated an association of short sleep duration with BMI. However, some of these studies also showed that long sleep duration was also associated with obesity. In contrast, other studies showed that neither long nor short sleep was associated with obesity. In paediatric populations there appeared to be a clear pattern where shorter sleep durations were associated with obesity. We did not locate any interventional studies where sleep duration had been manipulated in order to prevent or treat obesity. 3. We contend that the evidence base is not yet strong enough to give public health advice to the general population or specific groups about sleep duration being a modifiable risk factor for obesity. We need to experimentally clarify whether sleep duration variability is a risk factor for obesity, in what manner, and in which populations. If a reliable aetiological model could be found, we would ideally then need community-based randomised controlled trials that show that sleep duration can be changed and that sleep duration manipulation produces actual weight loss and/or prevents the development of obesity without undue side-effects.
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The association between short sleep and increased BMI is particularly strong and consistent in children.
“The association between short sleep and increased BMI is particularly strong and consistent in children [82, 100, 124].”
From Sleep and metabolic function (2012) · cites this paper as [100]
An ever-growing number of cross-sectional and case-control epidemiological studies have provided evidence of an independent link between short sleep (generally <6 hours per night in adults) and the risk of obesity.
“An ever-growing number of cross-sectional and case–control epidemiological studies (65 by 2009 [80]) have provided evidence of an independent link between short sleep (generally <6 h per night in adults) and the risk of obesity [82, 100, 124].”
From Sleep and metabolic function (2012) · cites this paper as [100]
Over 60 published articles have reported significant cross-sectional associations between short sleep duration (generally <6 hours per night) and increased prevalence of obesity or higher BMI.
“Over 60 published articles have reported significant cross-sectional associations between short sleep duration (generally <6 hours per night) and increased prevalence of obesity or higher BMI (see [124–126] for reviews).”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [124]
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Kessler, L., Nedeltcheva, A., Imperial, J., & Penev, P. D. (2010) · SLEEP · doi:10.1093/sleep/33.8.1115 · Cited by 68 · see citing works
Clinical relevance of sleep duration: results from a cross-sectional analysis using NHANES
Cepeda, M. S., Stang, P., Blacketer, C., Kent, J. M., & Wittenberg, G. M. (2016) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.5876 · Cited by 62 · see citing works
Bo, S., Ciccone, G., Durazzo, M., Ghinamo, L., Villois, P., Canil, S., Gambino, R., Cassader, M., Gentile, L., & Cavallo-Perin, P. (2011) · International Journal of Obesity · doi:10.1038/ijo.2011.5 · Cited by 61 · see citing works
Examining the Longitudinal Relationship Between Change in Sleep and Obesity Risk in Adolescents
Lytle, L. A., Murray, D. M., Laska, M. N., Pasch, K. E., Anderson, S. E., & Farbakhsh, K. (2013) · Health Education & Behavior · doi:10.1177/1090198112451446 · Cited by 61 · see citing works
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Agreement between simple questions about sleep duration and sleep diaries in a large online survey
Miller, C. B., Gordon, C. J., Toubia, L., Bartlett, D. J., Grunstein, R. R., D'Rozario, A. L., & Marshall, N. S. (2015) · Sleep Health · doi:10.1016/j.sleh.2015.02.007 · Cited by 44 · see citing works
Self-citationChanges in sleep duration and changes in weight in obese patients: The Swedish Obese Subjects Study
MARSHALL, N. S., GRUNSTEIN, R. R., PELTONEN, M., STENLOF, K., HEDNER, J., & SJOSTROM, L. V. (2010) · Sleep and Biological Rhythms · doi:10.1111/j.1479-8425.2010.00431.x · Cited by 17 · see citing works
Self-citation
- Authors
- Marshall, N. S., Glozier, N., & Grunstein, R. R.
- Affiliations
- The University of Sydney (AU)
- The George Institute for Global Health (AU)
- Corresponding author
- Marshall, Nathaniel S.
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2008-08
- Volume
- 12
- Issue
- 4
- Pages
- 289-298
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2023062650
- Cited by
- 415
- References
- 55
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 13 · 2023: 11 · 2022: 16 · 2021: 14 · 2020: 14 · 2019: 17 · 2018: 18 · 2017: 25 · 2016: 36 · 2015: 41 · 2014: 35 · 2013: 44 · 2012: 44
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep duration, obesity, body mass index, short sleep duration, long sleep, childhood obesity, obesity prevention, modifiable risk factors, longitudinal study, objective sleep measurement
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Cross-Sectional Studies, Cross-Cultural Comparison, Female, Humans, Life Style, Longitudinal Studies, Male, Middle Aged, Obesity, Risk Factors, Sleep Deprivation, Weight Gain, Health Behavior
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