Actigraphic sleep duration and fragmentation are related to obesity in the elderly: the Rotterdam Study

van den Berg, J F; Knvistingh Neven, A; Tulen, J H M; Hofman, A; Witteman, J C M; Miedema, H M E; Tiemeier, H

doi:10.1038/ijo.2008.57

Cited by 193Sleep and related disordersCircadian rhythm and melatoninSleep and Work-Related Fatigue

Actigraphic sleep duration and fragmentation are related to obesity in the elderly: the Rotterdam Study

van den Berg, J F, Knvistingh Neven, A, Tulen, J H M, Hofman, A, Witteman, J C M, Miedema, H M E, Tiemeier, H·2008·International Journal of Obesity

DOI 10.1038/ijo.2008.57

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Abstract

Objective The epidemiological evidence for the association between sleep duration and obesity in the elderly is inconsistent and has not been investigated with objective measures. Furthermore, the role of sleep fragmentation in this relationship is unknown. Our aim was to investigate the association of sleep measures with body mass index (BMI) and obesity in a normal elderly population.Design Cross-sectional study.Subjects A total of 983 community-dwelling elderly (mean age 68.4+/-6.9 years, range, 57-97).Measurements Weight and height were measured, and sleep duration and fragmentation were assessed with on average six nights of actigraphy.Results A quadratic model adequately described the association between continuous measures of sleep duration and BMI. Actigraphic sleep duration had a significant U-shaped relationship with BMI (beta of quadratic term=0.30, 95% confidence interval (CI): 0.08, 0.52). Both short sleepers (<5 h: OR, 2.76 (95% CI: 1.38, 5.49), 5 to <6 h: OR, 1.97 (95% CI: 1.26, 3.08)) and long sleepers (>or=8 h: OR, 2.93 (95% CI: 1.39, 6.16)) were more likely to be obese, compared to participants who slept 7 to <8 h. BMI increased with 0.59 kg m(-2) per standard deviation of sleep fragmentation (95% CI: 0.34, 0.84). After adjustment for sleep fragmentation, the association between short sleep and obesity was no longer significant. Exclusion of participants with probable sleep apnea only marginally changed these associations. Self-reported habitual sleep duration was not associated with BMI or obesity.Conclusions Sleep duration, as measured with actigraphy, had a U-shaped relationship with BMI and obesity in an elderly population. A highly fragmented sleep is associated with a higher BMI and a higher risk of obesity, and may explain why short sleep is related to obesity. To preclude bias that can be introduced by self-report measures of sleep duration, using multiple measures of sleep parameters is recommended in future research.

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Four studies using objective measurements found a much stronger cross-sectional association than similar studies using self-reported data.
“In support of this hypothesis, four studies that performed objective measurements reported a much stronger cross-sectional association than other studies of similar cross-sectional design but using self-reported data [63, 125, 182, 190].”
From Sleep and metabolic function (2012) · cites this paper as [190]

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Authors: van den Berg, J. F., Knvistingh Neven, A., Tulen, J. H. M., Hofman, A., Witteman, J. C. M., Miedema, H. M. E., & Tiemeier, H.
Affiliations: Erasmus MC (NL)
Netherlands Organisation for Applied Scientific Research (NL)
Corresponding author: Tiemeier, H
ORCID: Tulen, J H M
Hofman, A
Tiemeier, H
Venue: International Journal of Obesity
Publisher: Springer Science and Business Media LLC
Published: 2008-04-15
Volume: 32
Issue: 7
Pages: 1083-1090
ISSN: 0307-0565 (ISSN-L)
1476-5497
DOI: 10.1038/ijo.2008.57
OpenAlex: W2158129434
Cited by: 193
References: 39
Citations by year: 2026: 2 · 2025: 7 · 2024: 8 · 2023: 7 · 2022: 4 · 2021: 11 · 2020: 10 · 2019: 17 · 2018: 7 · 2017: 9 · 2016: 14 · 2015: 24 · 2014: 10 · 2013: 13 · 2012: 12
FWCI: 16.81
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: International Journal of Obesity (publishedVersion)
PubMed (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
TNO Repository (submittedVersion)
Repository hosted by TU Delft Library (TU Delft) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Keywords: sleep duration, sleep fragmentation, obesity, older adults, body mass index, actigraphy, short sleep duration, long sleep, U-shaped relationship, sleep apnea, self-reported sleep duration
MeSH terms: Aged, Aged, 80 and over, Body Height, Body Weight, Cross-Sectional Studies, Female, Humans, Life Style, Male, Middle Aged, Obesity, Risk, Sleep Deprivation, Body Mass Index, Linear Models, Odds Ratio

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Actigraphic sleep duration and fragmentation are related to obesity in the elderly: the Rotterdam Study

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