258803 Sleep troubled teenagers get more weight in Taiwan: A propensity score matching approach

Tuesday, October 30, 2012

Duan-Rung Chen , College of Public Health, National Taiwan University, Taipei, Taiwan
Khoa Truong, PhD , Department of Public Health Sciences, Clemson University, Clemson, SC
Meng-Ju Tsai , Meng-Ju Clinics, Meng-Ju Clinics, Hsin-chu, Taiwan
Background: The linkage between sleep quality and weight status among teenagers has gained more attention in the recent literature and health policy but no consensus has been researched. Methods: Using both propensity score method and multivariate linear regression for a cross-sectional sample of 2,113 teenagers, we analyzed their body mass index (BMI) in relation to sleep quality in the past four weeks while controlling for family characteristics (household income, parent/guardian level of education, disability status, work night shift, smoking) and individual factors (age, gender, regular exercise, smoking, employment, feeling secure in the neighborhood). Sleep quality was assessed using three scales “difficulty in initiating sleep”, “difficulty in maintaining sleep”, and “non-restorative sleep”, based on DSM-IV-defined insomnia. Results: Considering all three types of poor sleep quality, 20.9% of teenagers in Taiwan experienced some form of sleep problems. After adjusting for the other variables, two factors were found to independently and statistically predict sleep problems: current smoking (p<0.001) and work night shifts of household head (p<0.05). Teens who experienced “difficulty in initiating sleep” had higher BMI with an average increase of 0.86 BMI unit in Kernel matching (p<0.05) and 1.41units in 1-to-4 nearest neighbor matching (p<0.05). This statistically significant relationship was confirmed in the regression analysis. However, BMI was not associated with the other two scales of sleep quality. Conclusion: Efforts to address childhood overweight and obesity need to take into consideration sleep problems that are highly prevalent among teenagers. Further research on other dimensions of sleep quality and BMI is warranted.

Learning Areas:
Social and behavioral sciences

Learning Objectives:
What is already known on this subject? Some evidence from sleep physiology studies suggests sleep deprivation induce insulin resistance and stimulate appetite, both of which contribute to increased body weight. However, given clinical studies’ small sample sizes, it is not clear if, at the population level, there is a relationship between sleep problems and body mass index among teenagers. What this study adds? This study found a positive relationship between sleep quality and body weight among teenagers even after taking into consideration family and individual characteristics. Teens who experienced “difficulty in initiating sleep” had higher body mass index, averaging an increase between 0.86 – 1.41 BMI units. Successful efforts to curb obesity and insomnia among adolescents need to take into account the relationship between these two health issues.  

Keywords: Obesity, Adolescents, International

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Associate Professor, Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan. I wrote this abstract
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.