Abstract
Purpose of Review
To review the evidence on the relationship between daytime napping and obesity.
Recent Findings
There is concern that napping may be harmful to metabolic health. Prospective studies have shown long time daytime napping (> 1 h) is associated with increased diabetes risk which may be partly associated with obesity. Evidence from numerous cross-sectional studies and meta-analyses of cross-sectional studies have shown that long time napping (> 1 h) but not short time napping is associated with increased risk of obesity, and this is seen worldwide. Inference regarding the nature of association from cross-sectional studies is limited; it is suggested the association is bidirectional. Prospective studies on the association between daytime napping and obesity are few and results unclear.
Summary
Large longitudinal studies integrating daytime napping duration and night-time sleep behaviour and detailed information on lifestyle influences is needed to help elucidate further the associations of long time napping with obesity.
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Introduction
Daytime napping changes over the lifespan. Napping is common in infancy and early childhood, becomes less frequent in younger adults and becomes more common again in the elderly [1]. Daytime napping or siesta in adults is a common lifestyle practice in many countries worldwide and is thought to be a health promoting habit to improve mental health, cognitive performance, and work effectiveness particularly in sleep deprived populations such as night shift workers and airline pilots [1, 2]. However, this notion has been controversial because of the mounting evidence to suggest that long term daytime napping may be harmful to metabolic health and chronic disease risk [2, 3]. Numerous prospective studies and meta-analysis of prospective studies have shown daytime napping to be associated with increased Type 2 diabetes(T2DM) risk [4,5,6,7,8,9,10] and evidence indicate that long daytime naps (> 1 h/day) but not short naps are associated with increased T2DM risk [5, 6]. There have been suggestions that the association between napping and incident T2DM may be largely associated with obesity [7, 8, 10], a major causal risk factor for diabetes. Over the last decade much attention has turned to sleep patterns and obesity and a growing number of studies, mostly cross sectional in nature have investigated the association between napping and obesity particularly from studies in Chinese Populations. Numerous but not all studies have shown napping to be associated with obesity [11] and there is suggestion that duration of napping matters. Two recent meta-analysis on napping and obesity indicated that long daytime but not short daytime napping is associated with increased obesity risk [11, 12]. Napping is not a homogenous habit around the world. The effects of napping on obesity in mediterranean countries where siesta is a cultural habit or in China where midday napping is a common social habit may differ from effects in countries such as the UK and the US where siestas/napping are not culturally embedded. It is well documented that sleep loss or short sleep is associated with obesity and T2DM [13,14,15]; daytime napping may be a marker of insufficient sleep or poor sleep quality [16, 17]. It has also been suggested that the association between napping and obesity may be bidirectional with obesity leading to daytime napping [18]. In this article we review the evidence that daytime napping is associated with obesity in adults, whether the associations differ worldwide, whether duration of napping matters, and potential explanations which drive this association between napping and obesity.
Daytime Napping and Obesity-Cross Sectional Studies
Evidence that napping is associated with obesity have come mainly from cross sectional studies. In 2022, a systematic review of 11 studies on napping and obesity conducted by Sun et al. as part of a comprehensive review and meta-analysis of studies on daytime napping and CVD risk factors and mortality, indicated inconsistent results between studies although most of the studies reviewed tend to show napping to be associated with higher odds of obesity [11]. In a meta-analysis of daytime napping and obesity conducted in 14 cross sectional studies including over 720,000 adults, the authors concluded that there was evidence that long daytime napping (> 1 h/d) is associated with obesity although there were inconsistencies between studies [11]. The association between daytime napping > 1 h and obesity were seen in all regions (Europe 5 studies, China 3 studies and Central Asia 1 study) and in both older and younger adults. However short daytime napping of < 1 h/d was not associated with higher odds of obesity. In a subsequent 2023 systematic review and meta-analysis of 12 studies which focussed specifically on napping and obesity conducted in China (5 studies), USA (5 studies), Spain (1 study) and the UK (1 study) Cai et al. concluded that daytime napping of more than 1 h was associated with increased odds of being obese [12]. No clear association was seen with short naps. Many of the studies overlapped in the two systematic reviews. In most of the studies included in the reviews daytime napping was self-reported. Subsequent to these reviews The Guangzhou Biobank cohort study of nearly 30,000 participants aged 50 + reported daytime nappers to have higher waist circumference (but not BMI) than non-nappers [10]. No information was available on duration of napping.
Daily naps are also a common habit in many Middle Eastern countries but studies from the Middle East were underrepresented in these two meta-analyses. Several studies conducted recently in the middle East/Persian populations have also shown daytime napping to be associated with increased obesity. In a study of 1683 adults aged > 37 years who participated in the Isfahan Study cohort study (Iran) daytime nappers showed higher BMI than non-nappers after taking education physical activity and smoking into account, but this was only seen in short nighttime sleepers (< 6 h/night) [19]. However, duration of daytime sleep was not available, and it is possible that the nappers with short sleep were more likely to nap longer; daytime napping in those with longer sleep are likely to have shorter naps hence the lack of association between napping and BMI. In The MASHAD study including over 9000 adults living in Iran, those who reported daily napping showed higher odds of obesity than non-nappers after adjustment for a range of factors including physical activity and education [adjusted odds ratio 95% CI for obesity = 1.34 (1.20–1.51]. No information was available for duration of sleep [20]. In another cross-sectional study of 400 young and middle-aged subjects (mean age 32.8 years) conducted in Muscat (Oman) [21], those who reported long afternoon napping (> 1 h) showed increased risk of obesity even after adjustment for possible confounders including physical activity. In the FASA PERSIAN COHORT study of over 10,000 subjects aged 35–70 years BMI increased with increasing daytime sleep duration even after adjustment for potential confounders including physical activity [22].
Other studies not included in the meta-analyses or systematic reviews conducted in Spain [23, 24] the UK [25], Japan [26] and the 26 countries study [27] have confirmed the findings of increased adiposity in those who napped a long time. In the PREDIMED-PLUS study of over 6000 adults aged 55–75 years from Spain, daytime napping > 90 min was associated with increased BMI [23]. In the ONTIME Study (Obesity, nutrigenetics, timing and Mediterranean Study) which included a mediterranean population of 3275 adults living in Spain (35% took siesta; 16% long siesta), long siesta (> 30 min) but not short siesta was associated with higher BMI levels compared to those reporting no siesta [24]. In a study of older British men aged > 71 years, napping > 1 h was associated with increased prevalence of obesity [25]. In a study of 189 community dwelling Japanese adults aged 80 years or older napping > 1 h showed increased odds of being obese compared to those reporting < 60 min nap even after adjustment for disease and physical activity [26]. In the 26-country study [27] comprising over 136,000 participants, the odds (95%CI) of being obese increased with duration of napping from 1.15 (1.11,1.20) in those napping < 1 h to 1.22 (1.15,1.13) in those napping > 1 h compared with non-nappers after adjusting for potential confounders.
Most all the studies to date on napping and obesity have relied on self-reporting. which might lead to recall bias. Reporting of daytime napping may be be influenced by sleep quality and emotion, potentially leading to obesity [12]. However, two studies from Japan and the US [26, 34] using objective measures of daytime napping (wrist actigraphy) have confirmed odds of obesity to increase with increase with increasing duration of daytime napping. Future studies incorporating objective measures, such as wrist actigraphy or polysomnography are needed which would provide more accurate and reliable information, to reduce potential bias associated with self-reported data.
Confounders
Although many of these cross-sectional studies have adjusted for factors which may be associated with napping and obesity such as physical activity most studies have not taken other factors which may influence napping and obesity into account in particular diet and medical conditions. The ONTIME study showed that higher energy intake at lunch preceding the siesta and delayed meals at night played a mediating role in the napping obesity association [24]. Many conditions such as diabetes, obstructive sleep apnea, depression or anxiety disorder, dementia have an increased likelihood of napping, and these conditions are associated with obesity [28, 29].
Effects of Sleep Loss and Daytime Napping on Obesity
Sleep is important in the restorative process of the body and its energy metabolism. Short nocturnal sleep is a common cause of daytime sleepiness, and it is becoming well recognised that sleep loss or short sleep duration is associated with obesity. A large body of epidemiologic evidence has linked short sleep duration with the development of obesity and other metabolic disorders such as diabetes [30,31,32,33]. Excessive daytime sleepiness is commonly assumed to be the result of disturbed or inadequate sleep; thus, napping may be a marker of sleep loss. However, several studies have examined the association between napping and obesity and the association is seen even after taking nighttime sleep, sleep apnoea or sleep factors that indicate insufficient nighttime sleep into account [20, 21, 27, 34,35,36] in multivariate analysis.
Day Time and Nighttime Sleeping Patterns
Naps taken to compensate for poor nighttime sleep may differ from naps taken for enjoyment. Devine et al. have shown three common patterns of sleep behaviour infrequent nappers with good nighttime sleep, frequent nappers with good nighttime sleep and nappers with poor night-time sleep [37]. Only one cross sectional study to date has explored the interaction between nighttime sleep and daytime sleep on obesity. The influence of napping on overweight/obesity was seen in both those who reported short sleep (< 6 h) as well as those reporting 6–8 h’ sleep but not in long nighttime sleepers after adjustment [adjusted OR = 1.61 (1.07,2.41), 1.62 (0.93,2.82) and 1.33 (0.77,2.29)] for the three sleep groups respectively [19] although the findings in the 6–8 h’ sleep group was not statistically significant despite similar magnitude of association seen in the short sleep group. This may be due to the small number of men who report short sleep in the 6–8-h group. No detail was available on duration of daytime napping. It is possible that the association between duration of daytime napping and obesity may vary according to nighttime sleep patterns.
Daytime Napping and Obesity—Prospective Studies
Cross-sectional studies cannot answer the question about the direction of the association between napping and obesity, but longitudinal studies may shed some light on the nature of the association. However, longitudinal studies on daytime napping and weight gain are few. Table 1 shows details of the longitudinal studies that have examined daytime napping and incident obesity or weight change. Several studies have shown long time napping to be associated with increased risk of developing the metabolic syndrome characterised by a set of cardiometabolic risk factors including abdominal obesity, hypertension, hypertriglyceridemia, and hyperglycaemia. In the Chinese Longitudinal study of over 13000 Chinese adults aged ≥ 45 years longer daytime napping (> 90 min/day) was significantly associated with higher incidence of metabolic syndrome (after 4 years follow-up). When examined by components longer daytime napping was associated with a 20% increased risk of central obesity [18]. In the Daily24 Multisite Cohort Study of 1016 adults from the US (median age 52 years) those who did not nap or napped less than 60 min had higher odds of weight loss (vs weight gain) compared to participants reporting longer nap durations [38]. The authors indicated that it is possible that longer daytime sleepiness causes weight gain through reduced physical activity. By contrast The Heinz Nixdorf Study in Germany of over 2800 adults aged 45–74 years showed no association between regular daytime napping and subsequent 5-year weight gain [39]. However, information on duration of napping was not available. This study compared all nappers to non-nappers without differentiating short nappers from long nappers. It is possible that short and long napping may have differing effects on weight gain; thus, combining the two groups may yield null associations. In the Spanish Sun Mediterranean Cohort of over 9400 adults aged 20–90 years living in Spain, long time nappers > 1 h/d showed no difference in odds of developing obesity compared to non-nappers but those who took short 30 min daily siesta had reduced odds of incident obesity (OR = 0.67,95%CI 0.46–0.96) [40]. However, when the combined effect of nighttime sleep and taking a siesta was assessed, those who reported short sleep (< 7 h/) and took more than 30 min daily siesta showed higher risk of becoming obese compared to those who slept > 7 h and taking a 30 min siesta; risk being over two-fold.
Obesity as a Risk Factor for Daytime Sleepiness
Most of the evidence on napping and obesity come from cross sectional studies and reverse causation cannot be excluded as a possible explanation. It has been suggested that the association between napping and obesity may be bidirectional [18]. Obesity has been associated with an increase in sleep pressure and napping may be a consequence of increased adiposity. It is well recognised that obesity is a major risk factor for obstructive sleep apnea (OSA) which is considered an important contributor to sleepiness in obesity [41, 42]. Over 70% of people with OAS are overweight or obese; OSA often results in excess daytime sleepiness [41]. Earlier cross-sectional studies have shown excessive daytime sleepiness to be associated with obesity in the absence of sleep disordered breathing or sleep apnea [43, 44]. Several longitudinal studies have shown obesity or weight gain to be associated with excessive day time sleepiness. In the Sleep and HEalth in women ("SHE") cohort study of 7051 women (mean age 45.7 years) from Uppsala Sweden, obesity predicted incident excessive day time sleepiness [45]. In the Penn State Adult longitudinal cohort of ~ 1400 individuals aged > 20 years, obesity and weight gain were associated with the incidence of excessive day time sleepiness [46]. In the Sleep Health Heart Study of over 1400 participants aged 40–64 years and with no history of OSA 5-year weight gain was associated with worsening of daytime sleepiness [47]. A systematic review of weight loss interventions suggested that weight loss interventions improve daytime sleepiness supporting the causal effect of obesity on daytime sleepiness [48]. It is suggested that obesity alone can be a significant factor leading to daytime sleepiness because of circadian abnormality rather than just being secondary to nighttime sleep disturbance or OSA [43, 49].
Short Naps and Obesity
There is no evidence that short naps usually defined as < 1 h/d is associated with obesity. By contrast short naps have been associated with reduced rate of metabolic diseases and lower weight gain [40, 50], and may be associated with other benefits (enhancing cognitive performance, reduce sleepiness and improving mood) [1]. Recent studies have shown short naps usually defined as < 30 min to have health benefits on cognitive and structural brain outcomes [51, 52].
Genetic Studies of Excessive Daytime Napping with Obesity
Evidence that daytime napping may be causally related to obesity have come from genetic studies. Mendelian randomisation (MR) analysis has provided a cost efficient and robust approach to demonstrate causal links between napping and obesity. A recent large -scale study of napping habits and genomes from 452,633 UK Biobank participants identified the genetic variants influencing the likelihood to nap and suggest that daytime napping is partly regulated by genes and not just by environmental or behavioural choice and traits like laziness [53]. Genome wide association studies using mendelian randomisation analysis has suggested that habitual napping can be a causal factor for obesity [53,54,55,56] and for the metabolic syndrome characterised by central obesity, hypertension, or elevated triglycerides [57]. Genetic variants for daytime sleepiness also overlapped those for other diseases and lifestyle traits, with evidence that higher BMI and possibly diabetes are causally associated with increased daytime sleepiness [55,56,57] supporting a bidirectional relationship between daytime napping and obesity. However, the validity of an MR study for making causal inference assumes that the genetic variants have no other influence on the outcome, except through napping and that there are no confounders of the genetic variants-outcome association [58].
Mechanisms
The exact mechanisms underlying the association between daytime napping and obesity are still not clear. Some possible biological mechanisms have been proposed for the association of daytime napping and obesity [12]. Recent studies suggest that long daytime napping may weaken the circadian rhythm and evidence form human and animal studies have suggested circadian mechanisms to be involved in the development of obesity [59,60,61]. However, the underlying biological basis remains complex. It has also been shown that excessive daytime napping is associated with elevated nighttime cortisol levels, which could increase insulin resistance and lead to abnormal blood lipids and fat distribution [62]. Long daytime napping may also increase sympathetic nervous system activity increasing cortisol levels which may promote eating behaviour and fat deposition leading to weight gain [63, 64]. In addition, long day time napping may reduce the total amount of calorie consumption and physical activity, which may cause decreased energy expenditure, leading to obesity [65].
Conclusion and Future Direction
Overall, the findings to date suggest that long term daytime napping (> 1 h) but not short daytime naps is associated with obesity and the association maybe bidirectional. The association of daytime napping and increased risk of obesity in seen in different populations worldwide. There is no evidence that short naps(< 30 min/d) are associated with obesity and may even be beneficial in promoting cognitive and memory performance. Prospective studies on napping and incident obesity cases or weight gain are relatively few although genetic studies suggest a causal relationship between long time napping and obesity. Moreover, most studies have relied on self-reporting which may be subject to recall bias. Large longitudinal studies incorporating objective measures of day time napping are required to assess the influence of napping on incident obesity or weight gain considering behavioural factors and medical conditions that may influence the association between long time napping and obesity. Future prospective studies in different populations worldwide integrating daytime napping duration and night-time sleep behaviour is needed to help elucidate further the associations of napping with obesity. Experimental studies on napping and obesity are still lacking and the mechanisms underlying the association between long daytime napping and obesity remain unclear. Further clinical and experimental studies are warranted to provide insight as to how long naps may contribute to obesity.
Data Availability
No datasets were generated or analysed during the current study.
References
Faraut B, Andrillon T, Vecchierini MF, Leger D. Napping: a public health issue. From epidemiological to laboratory studies. Sleep Medi Rev. 2017;35:85–100.
Mantua J, Spencer RMC. Exploring the nap paradox: are mid-day sleep bouts a friend or foe? Sleep Med. 2017;37:88–97.
Liu H, Wu Y, Zhu H, Wang P, Chen T, Xia A, et al. Association between napping and type 2 diabetes. Front Endocrinol (Lausanne). 2024;15:1294638.
Zhou R, Chen HW, Huang YN, Zhong Q, Li FR, Huang RD, et al. The association between daytime napping and risk of type 2 diabetes is modulated by inflammation and adiposity: Evidence from 435 342 UK-Biobank participants. J Diabetes. 2023;15(6):496–507.
Liu M, Liu M, Wang S, Sun Y, Zhou F, Sun H. Relationship between daytime napping with the occurrence and development of diabetes: a systematic review and meta-analysis. BMJ Open. 2023;13(9):e068554.
Yamada T, Shojima N, Yamauchi T, Kadowaki T. J-curve relation between daytime nap duration and type 2 diabetes or metabolic syndrome: A dose-response meta-analysis. Sci Rep. 2016;6:38075.
Hublin C, Lehtovirta M, Partinen M, Koskenvuo M, Kaprio J. Napping and the risk of type 2 diabetes: a population-based prospective study. Sleep Med. 2016;17:144–8.
Leng Y, Cappuccio FP, Surtees PG, Luben R, Brayne C, Khaw KT. Daytime napping, sleep duration and increased 8-year risk of type 2 diabetes in a British population. Nutr Metab Cardiovasc Dis. 2016;26(11):996–1003.
Guo VY, Cao B, Wong CKH, Yu YET. The association between daytime napping and risk of diabetes: a systematic review and meta-analysis of observational studies. Sleep Med. 2017;37:105–12.
Xiao JY, Zhang WS, Jiang CQ, Jin YL, Zhu F, Cheng KK, Lam TH, Xu L. Obesity indicators as mediators of association between daytime napping and type 2 diabetes mellitus: the Guangzhou Biobank Cohort Study. BMC Public Health. 2022;22(1):56.
Sun J, Ma C, Zhao M, Magnussen CG, Xi B. Daytime napping and cardiovascular risk factors, cardiovascular disease, and mortality: A systematic review. Sleep Med Rev. 2022;65:101682.
Cai Z, Yang Y, Zhang J, Liu Y. The relationship between daytime napping and obesity: a systematic review and meta-analysis. Sci Rep. 2023;13(1):12124.
Wu Y, Zhai L, Zhang D. Sleep duration and obesity among adults: a meta-analysis of prospective studies. Sleep Med. 2014;15(12):1456–62.
Tobaldini E, Fiorelli EM, Solbiati M, Costantino G, Nobili L, Montano N. Short sleep duration and cardiometabolic risk: from pathophysiology to clinical evidence. Nat Rev Cardiol. 2019;16(4):213–24.
Antza C, Kostopoulos G, Mostafa S, Nirantharakumar K, Tahrani A. The links between sleep duration, obesity and type 2 diabetes. J Endocrinol. 2021;252:125–41.
Masa JF, Rubio M, Pérez P, Mota M, de Cos JS, Montserrat JM. Association between habitual naps and sleep apnea. Sleep. 2006;29(11):1463–8.
Bixler EO, Vgontzas AN, Lin HM, Calhoun SL, Vela-Bueno A, Kales A. Excessive daytime sleepiness in a general population sample: the role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab. 2005;90(8):4510–5.
Wang J, Wu Z, Jin X, Jin R, Han Z, Zhang H, et al. Bidirectional Associations between Daytime Napping Duration and Metabolic Syndrome: A Nationally Representative Cohort Study. Nutrients. 2022;14(24):5292.
Mohammadifard N, Sajjadi F, Haghighatdoost F, Masoodi S, Sadeghi M, Roohafza H, et al. The association between daytime sleep and general obesity risk differs by sleep duration in Iranian adults. Ann Hum Biol. 2023;50(1):211–8.
Ghazizadeh H, Mobarra N, Esmaily H, Seyedi SMR, Amiri A, Rezaeitalab F, et al. The association between daily naps and metabolic syndrome: Evidence from a population-based study in the Middle-East. Sleep Health. 2020;6:684–9.
Al-Abri MA, Al Lawati I, Al ZF. Association of elevated glycated hemoglobin and obesity with afternoon napping for more than 1 h in young and middle-aged healthy adults. Front Psychiatry. 2022;13:869464.
Yazdanpanah MH, Homayounfar R, Khademi A, Zarei F, Shahidi A, Farjam M. Short sleep is associated with higher prevalence and increased predicted risk of cardiovascular diseases in an Iranian population: Fasa PERSIAN Cohort Study. Sci Rep. 2020;10(1):4608.
Papandreou C, Díaz-López A, Babio N, Martínez-González MA, Bulló M, Corella D, et al. Long Daytime Napping Is Associated with Increased Adiposity and Type 2 Diabetes in an Elderly Population with Metabolic Syndrome. J Clin Med. 2019;8(7):1053.
Vizmanos B, Cascales AI, Rodríguez-Martín M, Salmerón D, Morales E, Aragón-Alonso A, Scheer FAJL, Garaulet M. Lifestyle mediators of associations among siestas, obesity, and metabolic health. Obesity (Silver Spring). 2023;31(5):1227–39.
Chen A, Lennon L, Papacosta O, Wannamethee SG. Association of night-time sleep duration and daytime napping with all-cause and cause-specific mortality in older British men: Findings from the British Regional Heart Study. Sleep Med. 2023;109:32–9.
Kim M. Association between objectively measured sleep quality and obesity in community-dwelling adults aged 80 years or older:a cross sectional study. J Korean Med Sci. 2015;30:199–206.
Tse LA, Wang C, Rangarajan S, Liu Z, Teo K, Yusufali A. Timing and Length of Nocturnal Sleep and Daytime Napping and Associations With Obesity Types in High-, Middle-, and Low-Income Countries. JAMA Netw Open. 2021;4(6):e2113775.
Leger D, Torres MJ, Bayon V, Hercberg S, Galan P, Chennaoui M, et al. The association between physical and mental chronic conditions and napping. Sci Rep. 2019;9:1795.
Zhang Z, Xiao X, Ma W, Li J. Napping in older adults: a review of current literature. Curr Sleep Med Rep. 2020;6:129–35.
Bacaro V, Ballesio A, Cerolini S, Vacca M, Poggiogalle E, Donini LM, Lucidi F, Lombardo C. Sleep duration and obesity in adulthood: An updated systematic review and meta-analysis. Obes Res Clin Pract. 2020;14:301–9.
Zhou Q, Zhang M, Hu D. Dose-response association between sleep duration and obesity risk: a systematic review and meta-analysis of prospective cohort studies. Sleep Breath. 2019;23:1035–45.
Itani O, Jike M, Watanabe N, Kaneita Y. Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Med. 2017;32:246–56 (Review).
Shan Z, Ma H, Xie M, Yan P, Guo Y, Bao W, et al. Sleep duration and risk of type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care. 2015;38(3):529–37.
Patel SR, Hayes AL, Blackwell T, Evans DS, Ancoli-Israel S, Wing YK, Stone KL, Osteoporotic Fractures in Men (MrOS); Study of Osteoporotic Fractures (SOF) Research Groups. The association between sleep patterns and obesity in older adults. Int J Obes (Lond). 2014;38(9):1159–64.
Wu J, Xu G, Shen L, Zhang Y, Song Yang S, et al. Daily sleep duration and risk of metabolic syndrome among middle-aged and older Chinese adults: cross sectional evidence from the Dongfeng-Tongji cohort study. BMC Public Health. 2015;15:178.
Loredo JS, Weng J, Ramos AR, Stores-Alvarez D, Simonelli G, Talavera GA, et al. Sleep patterns and obesity. Hispanic community health Study/Study of Latinos Sueno Ancillar Study. Chest. 2019;156:348–56.
Devine JK, Wolf JM. Integrating nap and night-time sleep into sleep patterns reveals differential links to health-relevant outcomes. J Sleep Res. 2016;25:225–33.
Hawkins Hawkins MS, Pokutnaya DY, Duan D, Coughlin JW, Martin LM, Zhao D, et al. Associations between sleep health and obesity and weight change in adults: The Daily24 Multisite Cohort Study. Sleep Health. 2023;9(5):767–73.
Kowall B, Lehnich AT, Erbel R, Moebus S, Jöckel KH. Stang A Associations between sleep characteristics and weight gain in an older population: results of the Heinz Nixdorf Recall Study. Nutr Diabetes. 2016;6(8):e225.
Sayón-Orea C, Bes-Rastrollo M, Carlos S, Beunza JJ, Basterra-Gortari FJ, Martínez-González MA. Association between sleeping hours and siesta and the risk of obesity: the SUN Mediterranean Cohort. Obes Facts. 2013;6(4):337–47.
Malhotra A, White DP. Obstructive sleep Apnoea. Lancet. 2002;360:237–45.
Li X, Wang T, Jin L, Li Z, Hu C, Yi H et al. Overall Obesity Not Abdominal Obesity Has a Causal Relationship with Obstructive Sleep Apnea in Individual Level Data. Nat Sci Sleep. 2023.
Vgontzas AN, Bixler EO, Tan TL, Kantner D, Martin LF, Kales A. Obesity without sleep apnea is associated with daytime sleepiness. Arch Intern Med. 1998;158:1333–7.
Resta O, Barbaro MPF, Bonfitto P, Giliberti T, Depalo A, Pannacciulli N, et al. Low sleep quality and daytime sleepiness in obese patients without obstructive sleep apnoea syndrome. J Intern Med. 2003;253:536–43.
Theorell-Haglöw J, Åkerstedt T, Schwarz J, Lindberg E. Predictors for Development of Excessive Daytime Sleepiness in Women: A Population-Based 10-Year Follow-Up. Sleep. 2015;38:1995–2003.
Fernandez-Mendoza J, Vgontzas AN, Kritikou I, Calhoun SL, Liao D, Bixler EO. Natural history of excessive daytime sleepiness: role of obesity, weight loss, depression, and sleep propensity. Sleep. 2015;38(3):351–60.
Ng WL, Orellana L, Shaw JE, Wong E, Peeters A. The relationship between weight change and daytime sleepiness: the Sleep Heart Health Study. Sleep Med. 2017;36:109–18.
Ng WL, Stevenson CE, Wong E, Tanamas S, Boelsen-Robinson T. Shaw JE et al Does intentional weight loss improve daytime sleepiness? A systematic review and meta-analysis. Obes Rev. 2017;18:460–75.
Panossian LA, Veasey SC. Daytime sleepiness in obesity: Mechanisms beyond obstructive sleep apnea-a review. Sleep. 2012;35:605–15.
Zhao X, Cheng L, Zhu C, Cen S, Lin W, Zheng W, Yang M, Yang F, Zhu S. A double-edged sword: the association of daytime napping duration and metabolism related diseases in a Chinese population. Eur J Clin Nutr. 2021;75(2):291–8.
Dutheil F, Danini B, Bagheri R, Fantini ML, Pereira B, Moustafa F, Trousselard M, Navel V. Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021;18(19):10212.
Paz V, Dashti HS, Garfield V. Is there an association between daytime napping, cognitive function, and brain volume? A Mendelian randomization study in the UK Biobank. Sleep Health. 2023;9(5):786–93.
Dashti HS, Daghlas I, Lane JM, Huang Y, Udler MS, Wang H, Ollila HM, Jones SE, Kim J, Wood AR, Weedon MN, Aslibekyan S, Garaulet M, Saxena R, 23andMe Research Team. Genetic determinants of daytime napping and effects on cardiometabolic health. Nat Commun. 2021;12(1):900. https://doi.org/10.1038/s41467-020-20585-3.
Celis-Morales C, Lyall DM, Guo Y, Steell L, Llanas D, Ward J. Sleep characteristics modify the association of genetic predisposition with obesity and anthropometric measurements in 119,679 UK Biobank participants. Am J Clin Nutr. 2017;105(4):980–90.
Wang H, Lane JM, Jones SE, Dashti HS, Ollila HM, Wood AR, et al. Genome-wide association analysis of self-reported daytime sleepiness identifies 42 loci that suggest biological subtypes. Nat Commun. 2019;10:3503.
Hayes BL, Vabistsevits M, Martin RM, Lawlor DA, Richmond RC. Robinson T Establishing causal relationships between sleep and adiposity traits using Mendelian randomization. Obesity (Silver Spring). 2023;31:861–70.
Yang Y, Wen L, Shi X, Yang C, Fan J, Zhang Y et al. Causal effects of sleep traits on metabolic syndrome and its components: a Medelian randomization study. Sleep and breathing. 2024. Online ahead of print.
Davies NM, Holmes MV, Davey SG. Reading mendelian randomisation studies: a guide, glossary, and checklist for clinicians. BMJ. 2018;362:k601.
Bray MS, Young ME. Circadian rhythms in the development of obesity: potential role for the circadian clock within the adipocyte. Obes Rev. 2007;8:169–81.
Martin MR, Perez-Sanz F, Zambrano C, Luján J, Ryden M, Scheer FA.J.L. Garaulet M. Research Symposium: Circadian Transcriptome oscillations in human adipose tissue depend on napping status and link to metabolic and inflammatory pathways. Sleep. 2024.
Schrader LA, Ronnekleive-Kelly SM, Hogenesch JB, Bradfield CA. McMalecki K Circadian disruption, clock genes and metabolic health. J Clin Invest. 2024;134:e170998.
Woods DL, Kim H, Yefimova M. To nap or not to nap: Excessive daytime napping is associated with elevated evening cortisol in nursing home residents with dementia. Biol Res Nurs. 2013;15(2):185–90.
Abboud F, Kumar R. Obstructive sleep apnea and insight into mechanisms of sympathetic overactivity. J Clin Invest. 2014;124:1454e7.
Davy KP, Orr JS. Sympathetic nervous system in human obesity. Neurosci Biobehav Rev. 2009;33:116–24.
Lucassen EA, Rother KI, Cizza G. Interacting epidemics? Sleep curtailment, insulin resistance, and obesity. Ann N Y Acad Sci. 2012;1264:110e34.
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Wannamethee, S.G. Napping and Obesity in Adults – What do we Know?. Curr Diab Rep (2024). https://doi.org/10.1007/s11892-024-01551-5
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DOI: https://doi.org/10.1007/s11892-024-01551-5