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Timing and Length of Nocturnal Sleep and Daytime Napping and Associations with Obesity Types in High-, Middle-, and Low-Income Countries

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dc.contributor.authorTse, Lap Ah
dc.contributor.authorWang, Chuangshi
dc.contributor.authorRangarajan, Sumathy
dc.contributor.authorLiu, Zhiguang
dc.contributor.authorTeo, Koon
dc.contributor.authorYusufali, Afzalhussein
dc.contributor.authorAvezum, Alvaro
dc.contributor.authorWielgosz, Andreas
dc.contributor.authorRosengren, Annika
dc.contributor.authorKruger, Iolanthé M.
dc.contributor.authorChifamba, Jephat
dc.contributor.authorTumerdem Calik, Kevser Burcu
dc.contributor.authorTumerdem Calik, Kevser Burcu
dc.contributor.authorZatońska, Katarzyna
dc.contributor.authorAlHabib, Khalid F.
dc.contributor.authorYusoff, Khalid
dc.contributor.authorKaur, Manmeet
dc.contributor.authorIsmail, Noorhassim
dc.contributor.authorSeron, Pamela
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorPoirier, Paul
dc.contributor.authorGupta, Rajeev
dc.contributor.authorKhatib, Rasha
dc.contributor.authorKelishadi, Roya
dc.contributor.authorLear, Scott A.
dc.contributor.authorChoudhury, Tarzia
dc.contributor.authorMohan, Viswanathan
dc.contributor.authorLi, Wei
dc.contributor.authorYusuf, Salim
dc.contributor.researchgroupMasiraspa
dc.date.accessioned2022-02-18T15:52:12Z
dc.date.available2022-02-18T15:52:12Z
dc.date.issued2021-06-30
dc.descriptionDigitalspa
dc.description.abstractImportance Obesity is a growing public health threat leading to serious health consequences. Late bedtime and sleep loss are common in modern society, but their associations with specific obesity types are not well characterized. Objective To assess whether sleep timing and napping behavior are associated with increased obesity, independent of nocturnal sleep length. Design, 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. Participants were aged 35 to 70 years and were mainly recruited during 2005 and 2009. Data analysis occurred from October 2020 through March 2021. Exposures Sleep timing (ie, bedtime and wake-up time), nocturnal sleep duration, daytime napping. 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. Multilevel logistic regression models with random effects for study centers were performed to calculate adjusted odds ratios (AORs) and 95% CIs. Results Overall, 136 652 participants (81 652 [59.8%] women; mean [SD] age, 51.0 [9.8] years) were included in analysis. A total of 27 195 participants (19.9%) had general obesity, and 37 024 participants (27.1%) had abdominal obesity. 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 19 660 participants (14.4%) had late bedtime behavior (ie, midnight or later). 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). 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). Neither going to bed during the day (ie, before 8pm) nor wake-up time was associated with obesity. Conclusions 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. Strategic weight control programs should also encourage earlier bedtime and avoid short nocturnal sleep to mitigate obesity epidemic.spa
dc.description.notesCorrection: This article was corrected on August 4, 2021, to correct an error in the Funding/Supportspa
dc.description.researchareaCiencias Médicas y de la Saludspa
dc.format.extent14 pspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doi10.1001/jamanetworkopen.2021.13775
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/6049
dc.language.isoengspa
dc.publisherJAMAspa
dc.publisher.placeUSAspa
dc.relation.citationendpage14spa
dc.relation.citationissue6spa
dc.relation.citationstartpage1spa
dc.relation.citationvolume4spa
dc.relation.indexedScopusspa
dc.relation.ispartofjournalJAMA Network Openspa
dc.rights© 2021 Tse LA et al. JAMA Network Openspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://jamanetwork.com/journals/jamanetworkopen/fullarticle/2781513spa
dc.subject.proposalBody-Mass Indexeng
dc.subject.proposalCaloric-Intakeeng
dc.subject.proposalWeight-Gaineng
dc.subject.proposalAdultseng
dc.subject.proposalMetanalysiseng
dc.subject.proposalDurationeng
dc.subject.proposalImpacteng
dc.subject.proposalRiskeng
dc.subject.proposalAgeeng
dc.subject.proposalChronotypeeng
dc.titleTiming and Length of Nocturnal Sleep and Daytime Napping and Associations with Obesity Types in High-, Middle-, and Low-Income Countriesspa
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dcterms.audienceTodas las Audienciasspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
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