Sleep problems in adolescence and overweight/obesity in young adults: is there a causal link?

Objective: This study aims to explore if there is a causal association between adolescence sleep problems and overweight/obesity (Ow/Ob) in young adults. Methods: Youth self-reports were used to explore if adolescence (mean age 13.90 years, SD +/- 0.32) sleep problems lead to general Ow/Ob, computed from body mass index (n = 1075), or abdominal Ow/Ob, computed from waist circumference and waist to height ratio (n = 1179), in young adults (mean age 20.65 years, SD +/- 0.82). Directed acyclic graphs were used to identify potential confounders, modified Poisson regression with a robust error variance was used to model the associations, and inverse probability weights were used to account for loss to follow-up. Results: At adolescence, 27.37% of the subjects reported having frequent sleep problems, and about a fifth of these subjects (22.65%) developed general Ow/Ob at young adulthood. Unadjusted regression analysis indicates a link between adolescent sleep problems and general Ow/Ob in young adults (incidence rate ratio [IRR]: 1.34, 95% confidence interval [CI]: 1.08-2.03), and this link was robust to adjustment for potential confounders (IRR: 1.47, 95% CI: 1.07-2.02). However, no such association was seen for adolescence sleep problems, and abdominal Ow/Ob computed from waist circumference (IRR: 1.30, 95% CI: 0.91-1.87) and waist to height ratio (IRR: 1.27, 95% CI: 0.86-1.88). Conclusion: Although there is evidence for a causal association between sleep problems and general Ow/Ob, the link between sleep problems and abdominal Ow/Ob needs more research to produce conclusive results. Nonetheless, behavioral interventions encouraging healthy sleep practice in young subjects are likely to influence future Ow/Ob outcome. (c) 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.