![]() ![]() 11 - 13 Emerging studies showed that napping during the daytime may reflect weakened circadian rhythm involved in the development of obesity, but the evidence from large studies is limited. Late bedtime behavior was found to be associated with obesity independent of sleep duration, but the findings are mixed. Increased exposure to light at night may make people go to bed late. 7 However, there has been no guideline on the optimal timing to wake-up and go to sleep (ie, bedtime). 6 Existing epidemiological studies widely demonstrated that chronic sleep loss behavior is associated with risk of weight gain and obesity, 7 - 10 and the American Academy of Sleep Medicine and Sleep Research Society recommends that adults should sleep 7 or more hours per night regularly to promote optimal health, including healthy weight. ![]() ![]() 5 Sleep loss is becoming more common, with approximately one-third of adults sleeping less than 6 hours per night. 1 - 3 Globally, the prevalence of obesity in adults has doubled since 1980, 4 which parallels decreased duration of sleep in modern society, possibly driven by high social and behavioral demands around the clock from work and increased modern technology keeping people awake at night. Obesity is an evolving public health concern leading to serious health consequences of diabetes, cardiovascular diseases, cancer, and premature death. Strategic weight control programs should also encourage earlier bedtime and avoid short nocturnal sleep to mitigate obesity epidemic. Neither going to bed during the day (ie, before 8 pm) nor wake-up time was associated with obesity.Ĭonclusions and Relevance This cross-sectional study found that late nocturnal bedtime and short nocturnal sleep were associated with increased risk of obesity prevalence, while longer daytime napping did not reduce the risk but was associated with higher risk of abdominal obesity. Short nocturnal sleep of less than 6 hours was associated with general obesity (eg, <5 hours: AOR, 1.27 95% CI, 1.13-1.43), but longer napping was associated with higher abdominal obesity prevalence (eg, ≥1 hours: AOR, 1.39 95% CI, 1.31-1.47). Compared with bedtime between 8 pm and 10 pm, late bedtime was associated with general obesity (AOR, 1.20 95% CI, 1.12-1.29) and abdominal obesity (AOR, 1.20 95% CI, 1.12-1.28), particularly among participants who went to bed between 2 am and 6 am (general obesity: AOR, 1.35 95% CI, 1.18-1.54 abdominal obesity: AOR, 1.38 95% CI, 1.21-1.58). A total of 19 660 participants (14.4%) had late bedtime behavior (ie, midnight or later). The mean (SD) nocturnal sleep duration was 7.8 (1.4) hours, and the median (interquartile range) midsleep time was 2:15 am (1:30 am-3:00 am). A total of 27 195 participants (19.9%) had general obesity, and 37 024 participants (27.1%) had abdominal obesity. Results Overall, 136 652 participants (81 652 women mean age, 51.0 years) were included in analysis. Multilevel logistic regression models with random effects for study centers were performed to calculate adjusted odds ratios (AORs) and 95% CIs. Main Outcomes and Measures The primary outcomes were prevalence of obesity, specified as general obesity, defined as body mass index (BMI calculated as weight in kilograms divided by height in meters squared) of 30 or greater, and abdominal obesity, defined as waist circumference greater than 102 cm for men or greater than 88 cm for women. Data analysis occurred from October 2020 through March 2021.Įxposures Sleep timing (ie, bedtime and wake-up time), nocturnal sleep duration, daytime napping. ![]() Participants were aged 35 to 70 years and were mainly recruited during 20. Objective To assess whether sleep timing and napping behavior are associated with increased obesity, independent of nocturnal sleep length.ĭesign, Setting, and Participants This large, multinational, population-based cross-sectional study used data of participants from 60 study centers in 26 countries with varying income levels as part of the Prospective Urban Rural Epidemiology study. Late bedtime and sleep loss are common in modern society, but their associations with specific obesity types are not well characterized. Importance Obesity is a growing public health threat leading to serious health consequences.
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