Skip to main content

Advertisement

SpringerLink
Log in

Dose-response association between sleep duration and obesity risk: a systematic review and meta-analysis of prospective cohort studies

  • Sleep Breathing Physiology and Disorders • Review
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

The association between sleep duration and obesity risk remains unclear. We performed an updated meta-analysis to quantify a potential dose-response relation between sleep duration and risk of obesity. PubMed and Embase were searched for prospective cohort studies examining the association between sleep duration and risk of obesity that were published up to October 28, 2017. Random effects models were used to evaluate the pooled relative risks (RRs) and 95% confidence intervals (CIs) for the association of sleep duration and obesity. Restricted cubic splines were used to model the dose-response association. The meta-analysis included 12 studies (16 reports). We found a reverse J-shaped relation between sleep duration and obesity, with the lowest risk at 7–8-h sleep per day. Compared with 7-h sleep duration per day, the pooled relative risks for obesity were 1.09 (95% CI 1.05–1.14) for each 1-h decrement among individuals who slept < 7 h per day and 1.02 (95% CI 0.99–1.05) for each 1-h increment of sleep duration among individuals with longer sleep duration. Short sleep duration significantly increased the risk of obesity. Compared with 7-h sleep duration per day, the risk of obesity increases 9% for each 1-h decrease in sleep duration.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Leandra Abarca-Gomez ZAA, Hamid ZA, Abu-Rmeileh NM (2017) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet 390(10113):2627–2642. https://doi.org/10.1016/s0140-6736(17)32129-3

    Article  Google Scholar 

  2. Haslam DW, James WP (2005) Obesity. Lancet 366(9492):1197–1209. https://doi.org/10.1016/s0140-6736(05)67483-1

    Article  PubMed  Google Scholar 

  3. Kirszenblat L, van Swinderen B (2015) The yin and yang of sleep and attention. Trends Neurosci 38(12):776–786. https://doi.org/10.1016/j.tins.2015.10.001

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Shen X, Wu Y, Zhang D (2016) Nighttime sleep duration, 24-hour sleep duration and risk of all-cause mortality among adults: a meta-analysis of prospective cohort studies. Sci Rep 6:21480. https://doi.org/10.1038/srep21480

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Cappuccio FP, D’Elia L, Strazzullo P, Miller MA (2010) Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep 33(5):585–592

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gallicchio L, Kalesan B (2009) Sleep duration and mortality: a systematic review and meta-analysis. J Sleep Res 18(2):148–158. https://doi.org/10.1111/j.1365-2869.2008.00732.x

    Article  PubMed  Google Scholar 

  7. Cappuccio FP, D’Elia L, Strazzullo P, Miller MA (2010) Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 33(2):414–420. https://doi.org/10.2337/dc09-1124

    Article  PubMed  Google Scholar 

  8. Shan Z, Ma H, Xie M, Yan P, Guo Y, Bao W, Rong Y, Jackson CL, Hu FB, Liu L (2015) Sleep duration and risk of type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care 38(3):529–537. https://doi.org/10.2337/dc14-2073

    Article  PubMed  Google Scholar 

  9. Guo X, Zheng L, Wang J, Zhang X, Zhang X, Li J, Sun Y (2013) Epidemiological evidence for the link between sleep duration and high blood pressure: a systematic review and meta-analysis. Sleep Med 14(4):324–332. https://doi.org/10.1016/j.sleep.2012.12.001

    Article  PubMed  Google Scholar 

  10. Wang Y, Mei H, Jiang YR, Sun WQ, Song YJ, Liu SJ, Jiang F (2015) Relationship between duration of sleep and hypertension in adults: a meta-analysis. J Clin Sleep Med 11(9):1047–1056. https://doi.org/10.5664/jcsm.5024

    Article  PubMed  PubMed Central  Google Scholar 

  11. Cappuccio FP, Cooper D, D’Elia L, Strazzullo P, Miller MA (2011) Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J 32(12):1484–1492. https://doi.org/10.1093/eurheartj/ehr007

    Article  PubMed  Google Scholar 

  12. Leng Y, Cappuccio FP, Wainwright NW, Surtees PG, Luben R, Brayne C, Khaw KT (2015) Sleep duration and risk of fatal and nonfatal stroke: a prospective study and meta-analysis. Neurology 84(11):1072–1079. https://doi.org/10.1212/wnl.0000000000001371

    Article  PubMed  PubMed Central  Google Scholar 

  13. Wang D, Li W, Cui X, Meng Y, Zhou M, Xiao L, Ma J, Yi G, Chen W (2016) Sleep duration and risk of coronary heart disease: a systematic review and meta-analysis of prospective cohort studies. Int J Cardiol 219:231–239. https://doi.org/10.1016/j.ijcard.2016.06.027

    Article  PubMed  Google Scholar 

  14. Kronholm E, Partonen T, Laatikainen T, Peltonen M, Harma M, Hublin C, Kaprio J, Aro AR, Partinen M, Fogelholm M, Valve R, Vahtera J, Oksanen T, Kivimaki M, Koskenvuo M, Sutela H (2008) Trends in self-reported sleep duration and insomnia-related symptoms in Finland from 1972 to 2005: a comparative review and re-analysis of Finnish population samples. J Sleep Res 17(1):54–62. https://doi.org/10.1111/j.1365-2869.2008.00627.x

    Article  PubMed  Google Scholar 

  15. Knutson KL, Van Cauter E, Rathouz PJ, DeLeire T, Lauderdale DS (2010) Trends in the prevalence of short sleepers in the USA: 1975-2006. Sleep 33(1):37–45

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rowshan Ravan A, Bengtsson C, Lissner L, Lapidus L, Bjorkelund C (2010) Thirty-six-year secular trends in sleep duration and sleep satisfaction, and associations with mental stress and socioeconomic factors—results of the Population Study of Women in Gothenburg, Sweden. J Sleep Res 19(3):496–503. https://doi.org/10.1111/j.1365-2869.2009.00815.x

    Article  PubMed  Google Scholar 

  17. Van Cauter E, Knutson KL (2008) Sleep and the epidemic of obesity in children and adults. Eur J Endocrinol 159(Suppl 1):S59–S66. https://doi.org/10.1530/eje-08-0298

    Article  PubMed  PubMed Central  Google Scholar 

  18. Chaput JP, Despres JP, Bouchard C, Tremblay A (2008) The association between sleep duration and weight gain in adults: a 6-year prospective study from the Quebec Family Study. Sleep 31(4):517–523

    Article  PubMed  PubMed Central  Google Scholar 

  19. Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB (2006) Association between reduced sleep and weight gain in women. Am J Epidemiol 164(10):947–954. https://doi.org/10.1093/aje/kwj280

    Article  PubMed  Google Scholar 

  20. Kobayashi D, Takahashi O, Shimbo T, Okubo T, Arioka H, Fukui T (2013) High sleep duration variability is an independent risk factor for weight gain. Sleep Breath 17(1):167–172. https://doi.org/10.1007/s11325-012-0665-7

    Article  PubMed  Google Scholar 

  21. Gangwisch JE, Malaspina D, Boden-Albala B, Heymsfield SB (2005) Inadequate sleep as a risk factor for obesity: analyses of the NHANES I. Sleep 28(10):1289–1296

    Article  PubMed  Google Scholar 

  22. Hasler G, Buysse DJ, Klaghofer R, Gamma A, Ajdacic V, Eich D, Rossler W, Angst J (2004) The association between short sleep duration and obesity in young adults: a 13-year prospective study. sleep 27(4):661–666

    Article  PubMed  Google Scholar 

  23. Gutierrez-Repiso C, Soriguer F, Rubio-Martin E, Esteva de Antonio I, Ruiz de Adana MS, Almaraz MC, Olveira-Fuster G, Morcillo S, Valdes S, Lago-Sampedro AM, Garcia-Fuentes E, Rojo-Martinez G (2014) Night-time sleep duration and the incidence of obesity and type 2 diabetes. Findings from the prospective Pizarra study. Sleep Med 15(11):1398–1404. https://doi.org/10.1016/j.sleep.2014.06.014

    Article  PubMed  Google Scholar 

  24. Itani O, Kaneita Y, Murata A, Yokoyama E, Ohida T (2011) Association of onset of obesity with sleep duration and shift work among Japanese adults. Sleep Med 12(4):341–345. https://doi.org/10.1016/j.sleep.2010.09.007

    Article  PubMed  Google Scholar 

  25. Nishiura C, Hashimoto H (2010) A 4-year study of the association between short sleep duration and change in body mass index in Japanese male workers. J Epidemiol 20(5):385–390

    Article  PubMed  PubMed Central  Google Scholar 

  26. Xiao Q, Arem H, Moore SC, Hollenbeck AR, Matthews CE (2013) A large prospective investigation of sleep duration, weight change, and obesity in the NIH-AARP Diet and Health Study cohort. Am J Epidemiol 178(11):1600–1610. https://doi.org/10.1093/aje/kwt180

    Article  PubMed  PubMed Central  Google Scholar 

  27. Bjorkelund C, Bondyr-Carlsson D, Lapidus L, Lissner L, Mansson J, Skoog I, Bengtsson C (2005) Sleep disturbances in midlife unrelated to 32-year diabetes incidence: the prospective population study of women in Gothenburg. Diabetes Care 28(11):2739–2744

    Article  PubMed  Google Scholar 

  28. Stranges S, Cappuccio FP, Kandala NB, Miller MA, Taggart FM, Kumari M, Ferrie JE, Shipley MJ, Brunner EJ, Marmot MG (2008) Cross-sectional versus prospective associations of sleep duration with changes in relative weight and body fat distribution: the Whitehall II Study. Am J Epidemiol 167(3):321–329. https://doi.org/10.1093/aje/kwm302

    Article  PubMed  Google Scholar 

  29. Nagai M, Tomata Y, Watanabe T, Kakizaki M, Tsuji I (2013) Association between sleep duration, weight gain, and obesity for long period. Sleep Med 14(2):206–210. https://doi.org/10.1016/j.sleep.2012.09.024

    Article  PubMed  Google Scholar 

  30. Nishiura C, Hashimoto H (2014) Sleep duration and weight gain: reconsideration by panel data analysis. J Epidemiol 24(5):404–409

    Article  PubMed  Google Scholar 

  31. Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S, Miller MA (2008) Meta-analysis of short sleep duration and obesity in children and adults. Sleep 31(5):619–626

    Article  PubMed  PubMed Central  Google Scholar 

  32. Wu Y, Zhai L, Zhang D (2014) Sleep duration and obesity among adults: a meta-analysis of prospective studies. Sleep Med 15(12):1456–1462. https://doi.org/10.1016/j.sleep.2014.07.018

    Article  PubMed  Google Scholar 

  33. Well G, Shea B, O’Connell D, Robertson J, Peterson J, Welch V, Losos M, Tugwell P The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses

  34. Orsini N, Li R, Wolk A, Khudyakov P, Spiegelman D (2012) Meta-analysis for linear and nonlinear dose-response relations: examples, an evaluation of approximations, and software. Am J Epidemiol 175(1):66–73. https://doi.org/10.1093/aje/kwr265

    Article  PubMed  Google Scholar 

  35. Bekkering GE, Harris RJ, Thomas S, Mayer AM, Beynon R, Ness AR, Harbord RM, Bain C, Smith GD, Sterne JA (2008) How much of the data published in observational studies of the association between diet and prostate or bladder cancer is usable for meta-analysis? Am J Epidemiol 167(9):1017–1026. https://doi.org/10.1093/aje/kwn005

    Article  PubMed  Google Scholar 

  36. Hamling J, Lee P, Weitkunat R, Ambuhl M (2008) Facilitating meta-analyses by deriving relative effect and precision estimates for alternative comparisons from a set of estimates presented by exposure level or disease category. Stat Med 27(7):954–970. https://doi.org/10.1002/sim.3013

    Article  PubMed  Google Scholar 

  37. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188

    Article  CAS  PubMed  Google Scholar 

  38. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560. https://doi.org/10.1136/bmj.327.7414.557

    Article  PubMed  PubMed Central  Google Scholar 

  39. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Nishiura C, Noguchi J, Hashimoto H (2010) Dietary patterns only partially explain the effect of short sleep duration on the incidence of obesity. sleep 33(6):753–757

    Article  PubMed  PubMed Central  Google Scholar 

  41. Watanabe M, Kikuchi H, Tanaka K, Takahashi M (2010) Association of short sleep duration with weight gain and obesity at 1-year follow-up: a large-scale prospective study. Sleep 33(2):161–167

    Article  PubMed  PubMed Central  Google Scholar 

  42. Vgontzas AN, Fernandez-Mendoza J, Miksiewicz T, Kritikou I, Shaffer ML, Liao D, Basta M, Bixler EO (2014) Unveiling the longitudinal association between short sleep duration and the incidence of obesity: the Penn State Cohort. Int J Obes (Lond) 38(6):825–832. https://doi.org/10.1038/ijo.2013.172

    Article  CAS  Google Scholar 

  43. Sayon-Orea C, Bes-Rastrollo M, Carlos S, Beunza JJ, Basterra-Gortari FJ, Martinez-Gonzalez MA (2013) Association between sleeping hours and siesta and the risk of obesity: the SUN Mediterranean Cohort. Obes Facts 6(4):337–347. https://doi.org/10.1159/000354746

    Article  PubMed  PubMed Central  Google Scholar 

  44. Kobayashi D, Takahashi O, Deshpande GA, Shimbo T, Fukui T (2012) Association between weight gain, obesity, and sleep duration: a large-scale 3-year cohort study. Sleep Breath 16(3):829–833. https://doi.org/10.1007/s11325-011-0583-0

    Article  PubMed  Google Scholar 

  45. Chaput JP, Sjodin AM, Astrup A, Despres JP, Bouchard C, Tremblay A (2010) Risk factors for adult overweight and obesity: the importance of looking beyond the ‘big two’. Obes Facts 3(5):320–327. https://doi.org/10.1159/000321398

    Article  PubMed  PubMed Central  Google Scholar 

  46. Magee CA, Huang XF, Iverson DC, Caputi P (2010) Examining the pathways linking chronic sleep restriction to obesity. J Obes 2010:1–8. https://doi.org/10.1155/2010/821710

    Article  Google Scholar 

  47. Leproult R, Van Cauter E (2010) Role of sleep and sleep loss in hormonal release and metabolism. Endocr Dev 17:11–21. https://doi.org/10.1159/000262524

    Article  CAS  PubMed  Google Scholar 

  48. Chaput JP, Despres JP, Bouchard C, Tremblay A (2007) Short sleep duration is associated with reduced leptin levels and increased adiposity: results from the Quebec family study. Obes (Silver Spring) 15(1):253–261. https://doi.org/10.1038/oby.2007.512

    Article  CAS  Google Scholar 

  49. Spiegel K, Tasali E, Penev P, Van Cauter E (2004) Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 141(11):846–850

    Article  PubMed  Google Scholar 

  50. Schmid SM, Hallschmid M, Jauch-Chara K, Born J, Schultes B (2008) A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men. J Sleep Res 17(3):331–334. https://doi.org/10.1111/j.1365-2869.2008.00662.x

    Article  PubMed  Google Scholar 

  51. Taheri S, Lin L, Austin D, Young T, Mignot E (2004) Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med 1(3):e62. https://doi.org/10.1371/journal.pmed.0010062

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Ohida T, Kamal AM, Uchiyama M, Kim K, Takemura S, Sone T, Ishii T (2001) The influence of lifestyle and health status factors on sleep loss among the Japanese general population. Sleep 24(3):333–338

    Article  CAS  PubMed  Google Scholar 

  53. Stamatakis KA, Brownson RC (2008) Sleep duration and obesity-related risk factors in the rural Midwest. Prev Med 46(5):439–444. https://doi.org/10.1016/j.ypmed.2007.11.008

    Article  PubMed  Google Scholar 

  54. Cizza G, Requena M, Galli G, de Jonge L (2011) Chronic sleep deprivation and seasonality: implications for the obesity epidemic. J Endocrinol Investig 34(10):793–800. https://doi.org/10.3275/7808

    Article  CAS  Google Scholar 

  55. Kyrou I, Tsigos C (2009) Stress hormones: physiological stress and regulation of metabolism. Curr Opin Pharmacol 9(6):787–793. https://doi.org/10.1016/j.coph.2009.08.007

    Article  CAS  PubMed  Google Scholar 

  56. Tan DX, Manchester LC, Fuentes-Broto L, Paredes SD, Reiter RJ (2011) Significance and application of melatonin in the regulation of brown adipose tissue metabolism: relation to human obesity. Obes Rev 12(3):167–188. https://doi.org/10.1111/j.1467-789X.2010.00756.x

    Article  CAS  PubMed  Google Scholar 

  57. Puig-Domingo M, Guerrero JM, Menendez-Pelaez A, Reiter RJ (1989) Melatonin specifically stimulates type-II thyroxine 5′-deiodination in brown adipose tissue of Syrian hamsters. J Endocrinol 122(2):553–556

    Article  CAS  PubMed  Google Scholar 

  58. Prunet-Marcassus B, Desbazeille M, Bros A, Louche K, Delagrange P, Renard P, Casteilla L, Penicaud L (2003) Melatonin reduces body weight gain in Sprague Dawley rats with diet-induced obesity. Endocrinology 144(12):5347–5352. https://doi.org/10.1210/en.2003-0693

    Article  CAS  PubMed  Google Scholar 

  59. Puchalski SS, Green JN, Rasmussen DD (2003) Melatonin effect on rat body weight regulation in response to high-fat diet at middle age. Endocrine 21(2):163–167. https://doi.org/10.1385/endo:21:2:163

    Article  CAS  PubMed  Google Scholar 

  60. St-Onge MP, Perumean-Chaney S, Desmond R, Lewis CE, Yan LL, Person SD, Allison DB (2010) Gender differences in the association between sleep duration and body composition: the Cardia Study. Int J Endocrinol 2010:726071. https://doi.org/10.1155/2010/726071

    Article  PubMed  Google Scholar 

  61. Chandola T, Ferrie JE, Perski A, Akbaraly T, Marmot MG (2010) The effect of short sleep duration on coronary heart disease risk is greatest among those with sleep disturbance: a prospective study from the Whitehall II cohort. Sleep 33(6):739–744

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This study was funded by the National Natural Science Foundation of China (grant nos. 81373074, 81402752, and 81673260); the Natural Science Foundation of Guangdong Province (grant no. 2017A030313452); the Science and Technology Development Foundation of Shenzhen (grant nos. JCYJ 20170302143855721 and JCYJ 20170412110537191); and the Postgraduate Innovation Development Fund Project of Shenzhen University (grant no. 31500004151).

Author information

Authors and Affiliations

  1. Department of Preventive Medicine, Shenzhen University Health Science Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People’s Republic of China

    Qionggui Zhou, Zhang Ming & Hu Dongsheng

  2. Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

    Qionggui Zhou, Zhang Ming & Hu Dongsheng

  3. The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

    Qionggui Zhou

Authors
  1. Qionggui Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhang Ming
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hu Dongsheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Zhang Ming or Hu Dongsheng.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Not applicable for this meta-analysis in which all analyses were based on published literature.

Informed consent

Not applicable for this meta-analysis in which all analyses were based on published literature.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOC 1274 kb)

ESM 2 Additional file: ESM 2 was received; however, no citation was provided in the manuscript. Please provide the location of where to insert the citation in the main body of the text. Otherwise, kindly advise us on how to proceed.Please note that additional files should be cited in ascending numerical order in the main body of the text.Dear editor, ESM 2 is a list of all authors who contributed to this study. We added all authors in the Appendix by following to the Editors comments when submitting the paper for the first time: "Authorship-23 named authors is too many for this paper as it is a review and meta-analysis. Please prepare a study group and place the additional named authors there. You could perhaps place your co-authors who conducted the data collection into a study group and the remaining should be named authors. Place place the names of the study group on the title page as XXX study group, then prepare an Appendix with the names of all members of the study group-including the named authors on the title page. This will ensure in case of acceptance that all named authors will be searchable in PubMed". If possible, please add this author list behind the first author (Qionggui Zhou) in order when this article is published. Please do not hesitate to contact me if you have any problems or questions

(DOC 27 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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 23, 1035–1045 (2019). https://doi.org/10.1007/s11325-019-01824-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-019-01824-4

Keywords

Search

Navigation