title: The association between self-reported sleep quality and overweight in a Chinese population.
abstract: OBJECTIVE
  Sleep quality and obesity are associated with type 2 diabetes, hypertension, and metabolic syndrome. However, there is limited research on the association between sleep quality and obesity, and thus the aim of this study is to investigate this relationship in a Chinese population.
  
  
  METHODS
  Subjects were recruited from the Prevention Health Center of National Cheng Kung University Hospital. Anthropometric data and metabolic parameters were measured. Being overweight or obese was defined according to the recommendations of the Department of Health in Taiwan. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI).
  
  
  RESULTS
  Of the total 2,803 subjects, 1,059 were classified as normal weight, 1,127 were overweight, and 617 were obese. The global PSQI score were 6.30 ± 2.56, 6.61 ± 2.96, and 7.02 ± 2.95 in subjects who were normal weight, overweight, and obese, respectively (test for trend, P < 0.001). Of the variables tested in the multivariate linear regression model, female gender, being overweight, obesity, sleep duration, and alcohol drinking were significantly associated with global PSQI scores, and in the multivariate logistic regression model, female gender, being overweight, obesity, and sleep duration were independent predictors of poor sleepers after controlling for age, gender, BMI or different weight statuses, sleep duration, alcohol drinking, smoking, habitual exercise, hypertension, newly diagnosed diabetes, total cholesterol, high-density lipoprotein, triglyceride, estimated glomerular filtration rate, and alanine aminotransferase.
  
  
  CONCLUSIONS
  In conclusion, female gender, being overweight, obesity, and sleep duration were associated with poor sleep quality independent of cardiometabolic risk factors. In clinical practice, subjects who are obese, or even only overweight, should be evaluated for the presence of sleep disturbance.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Taiwan, Republic of China.
authors.forename: Hao-Chang
authors.initials: HC
authors.lastname: Hung
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Yang
authors.forename: Horng-Yih
authors.initials: HY
authors.lastname: Ou
authors.forename: Jin-Shang
authors.initials: JS
authors.lastname: Wu
authors.forename: Feng-Hwa
authors.initials: FH
authors.lastname: Lu
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Chang
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000886:Anthropometry; D044466:Asian People; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D015444:Exercise; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D050177:Overweight / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D057566:Self Report; D012890:Sleep; D012893:Sleep Wake Disorders / Q000150:complications / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D002784:Cholesterol; D000410:Alanine Transaminase