Meta-Analysis of Short Sleep Duration and Obesity in Children and Adults
Open accessAbstract
BACKGROUND: Recent epidemiological studies suggest that short sleep duration may be associated with the development of obesity from childhood to adulthood. OBJECTIVES: To assess whether the evidence supports the presence of a relationship between short sleep duration and obesity at different ages, and to obtain an estimate of the risk. METHODS: We performed a systematic search of publications using MEDLINE (1996-2007 wk 40), EMBASE (from 1988), AMED (from 1985), CINHAL (from 1982) and PsycINFO (from 1985) and manual searches without language restrictions. When necessary, authors were contacted. Criteria for inclusion were: report of duration of sleep as exposure, BMI as continuous outcome and prevalence of obesity as categorical outcome, number of participants, age, and gender. Results were pooled using a random effect model. Sensitivity analysis was performed, heterogeneity and publication bias were also checked. Results are expressed as pooled odds ratios (OR [95% confidence intervals, CIs]) and as pooled regression coefficients (beta; 95% CIs). RESULTS: Of 696 studies identified, 45 met the inclusion criteria (19 in children and 26 in adults) and 30 (12 and 18, respectively) were pooled in the meta-analysis for a total of 36 population samples. They included 634,511 participants (30,002 children and 604,509 adults) from around the world. Age ranged from 2 to 102 years and included boys, girls, men and women. In children the pooled OR for short duration of sleep and obesity was 1.89 (1.46 to 2.43; P < 0.0001). In adults the pooled OR was 1.55 (1.43 to 1.68; P < 0.0001). There was no evidence of publication bias. In adults, the pooled beta for short sleep duration was -0.35 (-0.57 to -0.12) unit change in BMI per hour of sleep change. CONCLUSIONS: Cross-sectional studies from around the world show a consistent increased risk of obesity amongst short sleepers in children and adults. Causal inference is difficult due to lack of control for important confounders and inconsistent evidence of temporal sequence in prospective studies.
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Sleep deprivation of less than 6 hours per night exacerbates metabolic dysregulation by elevating ghrelin and reducing leptin levels.
“Sleep deprivation (<6 h/night) exacerbates metabolic dysregulation by elevating ghrelin (appetite-stimulating hormone) and reducing leptin (satiety hormone) levels [27].”
From Obesity: Clinical Impact, Pathophysiology, Complications, and Modern Innovations in Therapeutic Strategies (2025) · cites this paper as [27]
In the adults section (page unavailable), the paper reports that short sleep is associated with reciprocal changes in leptin and ghrelin; its References list studies describing reduced leptin and elevated ghrelin. But it presents this as a suggested mechanism, says the human evidence comes from short-lived severe sleep-deprivation experiments, and does not establish that sleeping <6 hours per night causes metabolic dysregulation through these changes. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA meta-analysis of cross-sectional studies found a significant negative association between hours of sleep and body mass index; short sleep duration was significantly associated with obesity.
“A meta-analysis of cross-sectional studies found a significant negative association between hours of sleep and body mass index; short sleep duration was significantly associated with obesity.73”
Two meta-analyses of cross sectional studies found short sleep duration to be associated with the prevalence of the metabolic syndrome.
“Two meta-analyses of cross sectional studies found short sleep duration to be associated with the prevalence of the metabolic syndrome.73,74”
A meta-analysis across 23 studies of adults found a pooled odds ratio of 1.55 for the association between short sleep duration and obesity.
“A meta-analysis by Cappuccio and colleagues29 found that across 23 studies of adults, a pooled odds ratio of 1.55 was found.”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [29]
Analysis of 7 studies found that for every increased hour of sleep, body mass index was reduced by 0.35 points.
“Furthermore, analysis of 7 studies that examined linear relationships between sleep duration and body mass index as a continuous variable showed that for every increased hour of sleep, body mass index was reduced by 0.35 points.”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [29]
The same meta-analysis reported that children (1.89 [CI = 1.46-2.43]) and adults (1.55 [1.43-1.68]) were more likely to be obese (BMI > 30 kg/m2) if they were short sleepers.
“This same meta-analysis also reported that children (1.89 [CI = 1.46-2.43])and adults (1.55 [1.43-1.68])were more likely to be obese (BMI > 30 kg/ m 2 ) if they were short sleepers.”
From The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review (2024) · cites this paper as [82]
Cappuccio et al. 2008 meta-analysis reported that across 604,509 adults, a 1-h increase in sleep duration was associated with a 0.35 kg/m2 reduction in BMI.
“a 2008 meta-analysis of epidemiological studies on the association of self-reported sleep duration and obesity risk by Cappuccio et al. reported that, across 604,509 adults, a 1-h increase in sleep duration was associated with a 0.35 kg/m 2 reduction in BMI.82”
From The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review (2024) · cites this paper as [82]
In a meta-analysis, the pooled odds ratio linking short sleep to obesity was 1.89 in children.
“the pooled odds ratio (OR) linking short sleep to obesity was 1.89 (95% CI, 1.46–2.43; p<0.0001) in children”
From Sleep and metabolic function (2012) · cites this paper as [18]
In the same meta-analysis, the pooled odds ratio linking short sleep to obesity was 1.55 in adults.
“and 1.55 (95% CI, 1.43–1.68; p<0.0001) in adults [18].”
From Sleep and metabolic function (2012) · cites this paper as [18]
Chronic insufficient sleep is associated with elevated risk of long-term weight gain and obesity.
“and possibly also a reason for the previously observed elevated risk of long term weight gain and obesity in those who chronically suffer from insufficient sleep (Cappuccio et al., 2008).”
From Sleep restriction alters plasma endocannabinoids concentrations before but not after exercise in humans (2016) · cites this paper as Cappuccio et al., 2008
A meta-analysis of cross-sectional studies found a significant negative association between hours of sleep and body mass index; short sleep duration was significantly associated with obesity.
“A meta-analysis of crosssectional studies found a significant negative association between hours of sleep and body mass index; short sleep duration was significantly associated with obesity.73”
Sleep deprivation is associated with increased predisposition to obesity in both adults and children.
“increased predisposition to obesity (3) and insulin resistance (IR) (4) in both adults and children”
From Sleep architecture and glucose and insulin homeostasis in obese adolescents (2011) · cites this paper as [3]
A meta-analysis of 45 cross-sectional studies including 604,509 adults and 30,002 children confirmed the relationship between short sleep and obesity and quantified the associated risk (OR 1.55 for adults; OR 1.89 for children).
“A meta-analysis of 45 cross-sectional studies, including 604,509 adults and 30,002 children, confirmed the relationship between short sleep (generally fewer than five hours per night in adults and fewer than 10 hours per night in children) and obesity, and quantified the associated risk (OR 1.55; 1.43–1.68; OR 1.89; 1.46–2.43, for adults and children, respectively).13”
From Interacting epidemics? Sleep curtailment, insulin resistance, and obesity (2012) · cites this paper as [13]
One meta-analysis found that short sleep duration (<5 hours per night) significantly predicted prevalent obesity in adults (pooled odds ratio 1.55, 95% CI 1.43-1.68).
“One meta-analyses of data from many of these cross-sectional studies found that short sleep duration (<5 hours per night) significantly predicted prevalent obesity in adults (pooled odds ratio [OR] was 1.55, 95% confidence interval [CI]: 1.43–1.68) [129].”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [129]
Sleep loss is a risk factor for obesity in both children and adults worldwide.
“Epidemiological evidence supports a link between sleep loss and obesity.”
From The impact of sleep deprivation on food desire in the human brain (2013) · cites this paper as [1]
Sleep loss may lead to the development and/or maintenance of obesity through the potentially maladaptive selection of foods carrying obesogenic (weight-gain) potential.
“In summary, these findings contribute to a novel brain mechanism by which sleep loss may lead to the development and/or maintenance of obesity through the potentially maladaptive selection of foods carrying obesogenic (weight-gain) potential”
From The impact of sleep deprivation on food desire in the human brain (2013) · cites this paper as [1]
The novel brain mechanism explains the large-scale significant association between reduced sleep time and obesity reported in population level studies.
“thereby explaining the large-scale significant association between reduced sleep time and obesity reported in population level studies1.”
From The impact of sleep deprivation on food desire in the human brain (2013) · cites this paper as [1]
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Sleep Duration and Five-Year Abdominal Fat Accumulation in a Minority Cohort: The IRAS Family Study
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A Twin Study of Sleep Duration and Body Mass Index
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- Authors
- Cappuccio, F. P., Taggart, F. M., Kandala, N.-B., Currie, A., Peile, E., Stranges, S., & Miller, M. A.
- Affiliations
- University of Warwick (GB)
- Corresponding author
- Cappuccio, Francesco P.
- ORCID
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-05
- Volume
- 31
- Issue
- 5
- Pages
- 619-626
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2398753
- OpenAlex
- W1601020103
- Cited by
- 2,076
- References
- 39
- Citations by year
- 2026: 45 · 2025: 93 · 2024: 78 · 2023: 123 · 2022: 120 · 2021: 146 · 2020: 168 · 2019: 159 · 2018: 146 · 2017: 129 · 2016: 143 · 2015: 150 · 2014: 128 · 2013: 130 · 2012: 106
- FWCI
- 8.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Warwick (cc-by)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- short sleep duration, obesity, childhood obesity, adult obesity, body mass index, sleep duration, obesity risk, sleep and health
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Obesity, Risk Factors, Sleep Deprivation, Statistics as Topic, Body Mass Index, Odds Ratio
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