title: The impact of obesity and weight gain on development of sleep problems in a population-based sample.
abstract: OBJECTIVE
  The objective of this study was to investigate the role of obesity and weight gain in the development of sleep problems in a population-based cohort.
  
  
  METHODS
  A population-based sample of men (n = 1896, aged 40-79 years) and women (n = 5116, age ≥20 years) responded to questionnaires at baseline and follow-up after 10-13 years. Sleep problems were assessed through questions about difficulties initiating sleep (DIS), difficulties maintaining sleep (DMS), excessive daytime sleepiness (EDS), and insomnia. Body mass index (BMI) was calculated from self-reported weight and height at both baseline and follow-up, while confounding factors (physical activity, tobacco and alcohol use, somatic disease, and snoring) were based on responses at baseline.
  
  
  RESULTS
  Although overweight and obese subjects reported more sleep problems at baseline, there was no independent association between BMI level at baseline and development of new sleep problems. Subjects in the quartile with the highest rise in BMI with a weight gain exceeding 2.06 kg/m2 had a higher risk of developing DMS [adjusted odds ratio (OR) 1.58; 95% confidence interval (CI) 1.25-2.01), EDS (2.25; 1.65-3.06], and insomnia (2.78; 1.60-4.82). Weight gain was not associated with the development of DIS.
  
  
  CONCLUSIONS
  Weight gain is an independent risk factor for developing several sleep problems and daytime sleepiness. The presence of overweight and weight gain should be considered when treating patients with sleep problems.
authors.affiliation: Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden; Centre for Research and Development, Uppsala University, Uppsala, County Council of Gävleborg, Sweden. Electronic address: andreas.palm@lg.se.
authors.forename: Andreas
authors.initials: A
authors.lastname: Palm
authors.affiliation: Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.
authors.forename: Christer
authors.initials: C
authors.lastname: Janson
authors.affiliation: Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D006970:Disorders of Excessive Somnolence / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology; D012893:Sleep Wake Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires; D015430:Weight Gain; D055815:Young Adult
keywords: Insomnia; Obesity; Overweight; Sleep problems; Sleepiness; Weight gain