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Sleep quality, emotional and behavioral disturbances, and eating behavior in adolescents with obesity: a structural equation modeling

Schlafqualität, emotionale und Verhaltensstörungen sowie Essverhalten bei Jugendlichen mit Adipositas: ein Strukturgleichungsmodell

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Abstract

Background

Sleep disorders and emotional and behavioral disturbances, including unhealthy eating behaviors, are common findings in obesity. This study aimed to examine possible associations between the above factors in adolescents with obesity using structural equation modeling.

Methods

A total of 94 adolescents (30 girls, 64 boys) aged 11–17 (mean 14.9 ± 1.7) years with obesity (ICD-10 code E 66.0) entered the study. The Adolescent Sleep Wake Scale (ASWS) was used to evaluate sleep quality. The Achenbach Youth Self-Report for Ages 11–18 (YSR) questionnaire was used to evaluate emotional and behavioral disturbances. The Dutch Eating Behavior Questionnaire (DEBQ) was used for assessment of eating behavior. Structural equation modeling (SEM) was used to establish a predictive relationship between the variables under consideration.

Results

The model in which sleep quality was a predictor of emotional distress and disinhibited behavior (latent variables), and in which the latter, in turn, were predictors of the eating behavior subscales, fit the sample data very well. Poor sleep quality was a significant predictor of emotional distress and of disinhibited behavior. Emotional distress was a significant predictor of emotional and restrictive eating, and disinhibited behavior was a significant predictor of external eating.

Conclusion

Poor sleep quality may promote unhealthy eating habits in adolescents with obesity, most likely due to mediating effects of emotional distress and disinhibited behavior.

Zusammenfassung

Hintergrund

Schlafstörungen sowie emotionale und Verhaltensstörungen, einschließlich ungesunden Essverhaltens, sind häufige Befunde bei Adipositas. Ziel der vorliegenden Studie war es, mögliche Zusammenhänge zwischen den genannten Faktoren bei Jugendlichen mit Adipositas mithilfe eines Strukturgleichungsmodells zu untersuchen.

Methoden

An der Studie nahmen 94 Jugendliche (30 Mädchen und 64 Jungen) im Alter von 11–17 Jahren (Mittelwert 14,9 ± 1,7) mit Adipositas (ICD-10-Code E 66.0) teil. Zur Bewertung der Schlafqualität wurde die Adolescent Sleep Wake Scale (ASWS) verwendet. Der Fragebogen Achenbach Youth Self-Report for Ages 11–18 (YSR) wurde zur Bewertung emotionaler und verhaltensbezogener Störungen eingesetzt. Zur Beurteilung des Essverhaltens wurde der Dutch Eating Behavior Questionnaire (DEBQ) verwendet. Um eine prädiktive Beziehung zwischen den betrachteten Variablen herzustellen, wurde das Strukturgleichungsmodell angewandt.

Ergebnisse

Das Modell, in dem die Schlafqualität ein Prädiktor für die emotionale Belastung und das enthemmte Verhalten (latente Variablen) war, und Letztere wiederum Prädiktoren für die Subskalen des Essverhaltens darstellten, passte sehr gut zu den Stichprobendaten. Schlechte Schlafqualität war ein signifikanter Prädiktor für emotionalen Stress und enthemmtes Verhalten. Die emotionale Belastung war ein signifikanter Prädiktor für emotionales und restriktives Essen, und das enthemmte Verhalten war ein signifikanter Prädiktor für externes Essen.

Schlussfolgerung

Eine schlechte Schlafqualität kann ungesunde Essgewohnheiten bei Jugendlichen mit Adipositas begünstigen, höchstwahrscheinlich aufgrund der vermittelnden Wirkung von emotionaler Belastung und enthemmtem Verhalten.

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Acknowledgements

The author would like to thank postgraduate students for their help in collecting raw data.

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  1. Department of Children’s Diseases with Clinics, Institute for Medical Education of the V.A. Almazov National Medical Research Centre, 2 Akkuratova Str., 197341, St. Petersburg, Russian Federation

    Igor A. Kelmanson

  2. Department of Clinical Psychology, St. Petersburg State Institute for Psychology and Social Work, St. Petersburg, Russian Federation

    Igor A. Kelmanson

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Kelmanson, I.A. Sleep quality, emotional and behavioral disturbances, and eating behavior in adolescents with obesity: a structural equation modeling. Somnologie 27, 90–101 (2023). https://doi.org/10.1007/s11818-023-00405-8

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