Sleep duration and body mass index: moderating effect of self-perceived stress and age. Results of a cross-sectional population-based study

  • Adriana Rusu
  • Cornelia BalaEmail author
  • Mariana Graur
  • Gabriela Creteanu
  • Magdalena Morosanu
  • Gabriela Radulian
  • Amorin R. Popa
  • Romulus Timar
  • Lucretia Pircalaboiu
  • Gabriela Roman
Original Article
Part of the following topical collections:
  1. Sleep and Eating and Weight disorders



The objective of this analysis was to assess whether the association between sleep duration and BMI and between sleep duration and waist circumference is moderated by age and self-perceived stress.


We analyzed data from 2034 participants enrolled in 2014 in the cross-sectional study Obesity in Romania Study—study of the prevalence of obesity and related risk factors in Romanian general population (ORO study).


Interaction between sleep duration, self-perceived stress and age, with BMI as dependent variable, was statistically significant after adjustment for demographic and lifestyle factors (p value for interaction 0.003). In participants without self-perceived stress, a linear negative association between sleep duration and BMI was observed only in those 18–39 years old (p = 0.049), with BMI decreasing in parallel with increased sleep duration. In participants with self-perceived stress, a U-shaped relationship was observed between BMI and sleep duration in those 40–64 years old, with higher BMI in those sleeping ≤ 6 h and ≥ 9 h/night compared to those sleeping > 6 and < 9 h/night (p = 0.002 and 0.005). Those ≥ 65 years old with self-perceived stress sleeping ≥ 9 h/night had a significantly higher BMI compared to those in other sleep duration categories (p = 0.041 vs. those sleeping ≤ 6 h/night and p = 0.013 vs. to those sleeping > 6 and < 9 h/night). No interaction between age, self-perceived stress and sleep duration, with waist circumference as dependent variable was observed.


In our sample, the association between sleep duration and BMI was moderated by self-perceived stress and age.


Sleep duration Body mass index Waist circumference Age Self-perceived stress 



This work was supported by the Coca-Cola Foundation (Grant year 2013). Coca-Cola Foundation had no role in the study design, data collection analysis and interpretation, writing of this manuscript or decision to submit this manuscript.

Compliance with ethical standards

Conflict of interest

All authors declare fees from Coca Cola Foundation through Research Consulting Association during the conduct of the study. The authors have no non-financial conflict of interest to declare related to the conduct of the study and the development of the present manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

40519_2019_665_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 19 KB)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Adriana Rusu
    • 1
  • Cornelia Bala
    • 1
    Email author
  • Mariana Graur
    • 2
  • Gabriela Creteanu
    • 3
  • Magdalena Morosanu
    • 4
  • Gabriela Radulian
    • 5
  • Amorin R. Popa
    • 6
  • Romulus Timar
    • 7
  • Lucretia Pircalaboiu
    • 8
  • Gabriela Roman
    • 1
  1. 1.Department of Diabetes and NutritionIuliu Hatieganu University of Medicine and PharmacyCluj-NapocaRomania
  2. 2.Department of Diabetes, Nutrition and Metabolic DiseasesGr. T. Popa University of Medicine and Pharmacy, St. Spiridon Clinical Emergency HospitalIasiRomania
  3. 3.Emergency County HospitalSuceavaRomania
  4. 4.Dunarea de Jos UniversityGalaţiRomania
  5. 5.Carol Davila University of Medicine and PharmacyBucharestRomania
  6. 6.Faculty of Medicine and PharmacyUniversity of OradeaOradeaRomania
  7. 7.Victor Babes University of Medicine and PharmacyTimisoaraRomania
  8. 8.Emergency County HospitalTargu JiuRomania

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