Sex Differences in the Association between Sleep Quality and Excess Weight: Exploring Lifestyle and Health-Related Mediators.

IF 1.8 Q4 CLINICAL NEUROLOGY
Sleep Science Pub Date : 2025-09-16 eCollection Date: 2025-09-01 DOI:10.1055/s-0045-1809062
Thauanny Heslley Lima Dos Santos, Júlia Souza de Melo, Márcia de Oliveira Lima, Risia Cristina Egito de Menezes, Renan Serenini, Giovana Longo-Silva
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Abstract

Objective: To compare the associations between sleep quality and body mass index (BMI), as well as excess weight status, in male and female subjects, while exploring potential mediating factors, including lifestyle and health-related variables.

Materials and methods: The present cross-sectional study analyzed data from 5,260 (29.7% male and 70.3% female) Brazilian adults collected through a virtual survey applied from 2023 to 2024. Sleep quality and duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). The BMI was derived from self-reported weight and height, with excess weight defined as BMI > 24.9 kg/m 2 . Associations were explored using multiple linear and logistic regression models, marginal probabilities for being overweight, and restricted cubic splines. Potential mediating variables were identified through mediation analysis.

Results: Among the female subjects, poor sleep quality (β = 0.46; 95%CI: 0.15-0.77) and short sleep duration (β = 0.62; 95%CI: 0.27-0.97) were associated with higher BMI and 21% of increased odds of excess weight after adjusting for all covariates (age, depression, chronic conditions, level of schooling, marriage status, smoking, alcohol consumption, screen time before bed, physical activity, diet quality, and whether dinner is the largest meal of the day). The mediation analysis showed that chronic conditions (20%), depression (16%), and diet quality (14%) mediated the total effect of poor sleep quality on BMI in female participants. Screen time before bed was the only significant mediator for short sleep duration, accounting for ∼ 5% of the total effect. No significant associations were found in male subjects.

Conclusion: Our findings highlight sex differences in the relationship between sleep and BMI, emphasizing the need for sex-specific approaches to sleep and weight management, focusing on health and lifestyle improvements.

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睡眠质量和超重之间的性别差异:探索生活方式和健康相关的中介。
目的:比较男性和女性受试者的睡眠质量与体重指数(BMI)以及超重状态之间的关系,同时探索包括生活方式和健康相关变量在内的潜在中介因素。材料和方法:本横断面研究分析了2023年至2024年通过虚拟调查收集的5260名巴西成年人(29.7%为男性,70.3%为女性)的数据。使用匹兹堡睡眠质量指数(PSQI)评估睡眠质量和持续时间。BMI来源于自我报告的体重和身高,超重定义为BMI > 24.9 kg/ m2。使用多重线性和逻辑回归模型、超重的边际概率和受限三次样条来探讨相关关系。通过中介分析确定潜在的中介变量。结果:在女性受试者中,睡眠质量差(β = 0.46; 95%CI: 0.15-0.77)和睡眠时间短(β = 0.62; 95%CI: 0.27-0.97)与较高的BMI和21%的超重几率相关,在调整了所有协变量(年龄、抑郁症、慢性病、受教育程度、婚姻状况、吸烟、饮酒、睡前看屏幕时间、身体活动、饮食质量以及晚餐是否为一天中最大的一餐)之后。中介分析显示,慢性疾病(20%)、抑郁(16%)和饮食质量(14%)介导了女性参与者睡眠质量差对BMI的总影响。睡前屏幕时间是影响短睡眠时间的唯一显著中介,占总影响的约5%。在男性受试者中没有发现显著的关联。结论:我们的研究结果强调了睡眠和体重指数之间关系的性别差异,强调了针对性别的睡眠和体重管理方法的必要性,重点是改善健康和生活方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Sleep Science
Sleep Science CLINICAL NEUROLOGY-
CiteScore
2.50
自引率
12.50%
发文量
124
审稿时长
10 weeks
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