Relationships between body mass index and sleep quality and duration in adults 70 years and older

Tamar Shochat, Galia Shefer-Hilel, Anna Zisberg

Research output: Contribution to journalArticlepeer-review


Objective Associations between sleep and body mass index (BMI) are age dependent. In older adults, BMI norms representing “normal” and “overweight” combine into a single “normal-weight” category. We aimed to assess the nonlinear associations between age-appropriate BMI categories and sleep duration (SD) and sleep efficiency (SE) in older men and women, controlling for health and functional status. Methods Secondary data analysis of the Hospitalization Process Effects on Functional Outcomes and Recovery included 719 community-dwelling adults age 70+ years hospitalized because of nondisabling diagnoses. Self-report intake data regarding their condition prior to circumstances that led to hospitalization were used to obtain BMI categories (underweight: BMI ≤ 23, normal weight: 23 < BMI < 30, and obese: BMI ≥ 30), SD, SE, health, and functional status. Analysis of covariance was used for modeling SD and SE separately, additively entering (1) BMI, (2) sex and BMI × sex, and (3) health and functional confounders. Results For SD and SE, significant BMI group differences in the first model (P < .001) remained significant in the second (P < .001) and third (P < .01) models. High BMI was associated with shorter SD and lower SE compared with normal- and low-BMI groups. Controlling for sex, an inverted J-shaped relationship appeared in women, whereby low- and, more prominently, high-BMI categories were associated with shorter SD and lower SE compared with normal BMI. Although associations remained consistent in the fully adjusted models, effect sizes were small. Conclusions Findings provide insights into possible mechanisms underlying BMI, sleep, and health and may contribute to informed clinical recommendations, particularly for older women.

Original languageEnglish
Pages (from-to)266-271
Number of pages6
JournalSleep Health
Issue number4
StatePublished - 1 Dec 2016

Bibliographical note

Funding Information:
This work was supported by the Israeli Science Foundation (grant 565/08 ), Clalit Health Services (grant 04-121/2010 ), and Israel National Institute for Health Policy Research (thesis scholarship 35/2012 ). The funding agencies had no role in the design and conduct of this study, the analysis or interpretation of the data, or the preparation of the manuscript.

Publisher Copyright:
© 2016 National Sleep Foundation.


  • BMI
  • Older adults
  • Sleep duration
  • Sleep efficiency
  • Weight

ASJC Scopus subject areas

  • Behavioral Neuroscience


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