Main Article Content
Sleep duration, sleep efficiency, sleep quality, dietary intake
Objective: This study was planned to determine the associations between sleep duration, efficiency,
quality with dietary components in adults. Methods: This cross-sectional study was conducted with young
adults aged between 19-30 years. Sleep duration and efficiency were assessed with Metabolic Holter. Sleep
quality was assessed with Pittsburgh Sleep Quality Scale. Three consecutive days’ dietary record was taken at
the same time with metabolic holter. Body composition was analyzed with Bioelectric Impedance Analysis.
Results: Body fat mass, body fat percent, waist circumference, and waist/hip ratio was found higher in females
with poor sleep efficiency, and decreased sleep efficiency correlated with increased waist/hip ratio (r=-0.324;
p=0.054). Being female gender and decreased fat mass were shown as major predictors for increased sleep
efficiency according to regression analyses. Also, in females with poor sleep quality had higher percentage of
body fat mass and body mass index than females with good sleep quality (p<0.05). The body mass index and
waist/hip ratio were found higher in males with sleep duration <7 hours. Decreased sleep efficiency correlates
with increased body fat mass and the body fat percent in males (p<0.05). Daily dietary protein, tryptophan,
polyunsaturated fatty acids and cholesterol intake are significant higher in males who sleep ≥7 hours (p<0.05).
Conclusion: Poor sleep efficiency and short sleep duration in males and poor sleep efficiency in females is associated with increased obesity indicators. These associations were found to be partially related by nutrient
intakes, especially in males.
2. Reed DL, Sacco WP. Measuring Sleep Efficiency: What Should the Denominator Be? J Clin Sleep Med 2016;12(2):263-6.
3. Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 2002;6(2):97-111.
4. Grandner MA, Jackson N, Gerstner JR, Knutson KL. Dietary nutrients associated with short and long sleep duration. Data from a nationally representative sample. Appetite 2013;64:71-80.
5. Watanabe M, Kikuchi H, Tanaka K, Takahashi M. Association of short sleep duration with weight gain and obesity at 1-year follow-up: a large-scale prospective study. Sleep 2010;33(2):161-7.
6. Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep 2010;33(5):585-92.
7. Frank S, Gonzalez K, Lee-Ang L, Young MC, Tamez M, Mattei J.Diet and Sleep Physiology: Public Health and Clinical Implications. Front Neurol 2017; 8:393.
8. Lund HG, Reider BD, Whiting AB, Prichard JR.Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health 2010;46(2):124-132.
9. Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity 2008;16(3):643-653.
10. Laposky AD, Bass J, Kohsaka A, Turek FW. Sleep and circadian rhythms: key components in the regulation of energy metabolism. FEBS letters 2008;582(1):142-151.
11. Spiegel K, Leproult R, L'hermite-Balériaux M, Copinschi G, Penev PD, Van Cauter E. Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. J Clin Endocrinol Metab 2004; 89(11):5762-5771.
12. Spiegel K, Tasali E, Penev P, Van Cauter E. Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004;141(11):846-850.
13. Bertéus Forslund H, Lindroos AK, Sjöström L, Lissner L.Meal patterns and obesity in Swedish women-a simple instrument describing usual meal types, frequency and temporal distribution. Eur J Clin Nutr 2002;56(8):740-747.
14. Turek FW, Joshu C, Kohsaka A, Lin E, Ivanova G, McDearmon E, Laposky A, Losee-Olson S, Easton A, Jensen DR, Eckel RH, Takahashi JS, Bass J. Obesity and metabolic syndrome in circadian Clock mutant mice. Science 2005;308(5724):1043-1045.
15. Qin LQ, Li J, Wang Y, Wang J, Xu JY, Kaneko T. The effects of nocturnal life on endocrine circadian patterns in healthy adults. Life Sci 2003;73(19): 2467-2475.
16. Imaki M, Hatanaka Y, Ogawa Y, Yoshida Y, Tanada S. An epidemiological study on relationship between the hours of sleep and life style factors in Japanese factory workers. J Physiol Anthropol Appl Human Sci 2002; 21(2):15-120.
17. Nishiura C, Hashimoto H. A 4-year study of the association between short sleep duration and change in body mass index in Japanese male workers. J Epidemiol 2010;20(5):385-390.
18. Grandner MA, Drummond SP. Who are the long sleepers? Towards an understanding of the mortality relationship. Sleep Med Rev 2007;11(5):341-360.
19. Grandner MA, Patel NP, Gehrman PR, Perlis ML, Pack AI. Problems associated with short sleep: bridging the gap between laboratory and epidemiological studies. Sleep Med Rev 2010;14(4):239-247.
20. Knutson KL. Sleep duration and cardiometabolic risk: a review of the epidemiologic evidence. Best Pract Res Clin Endocrinol Meta 2010;24(5):731-743.
21. Haghighatdoost F, Karimi G, Esmaillzadeh A, Azadbakht L. Sleep deprivation is associated with lower diet quality indices and higher rate of general and central obesity among young female students in Iran. Nutrition 2012;28(11):1146-1150.
22. Tworoger SS, Yasui Y, Vitiello MV, Schwartz RS, Ulrich CM, Aiello EJ, Irwin ML, Bowen D, Potter JD, McTiernan A. Effects of a year long moderate-intensity exercise and a stretching intervention on sleep quality in postmenopausal women. Sleep 2003;26(7):830-836.
23. King AC, Castro CM, Buman MP, Hekler EB, Urizar GG Jr, Ahn DK.Behavioral impacts of sequentially versus simultaneously delivered dietary plus physical activity interventions: the CALM trial. Ann Behav Med 2013;46(2):157-168.
24. Landry GJ, Best JR, Liu-Ambrose T. Measuring sleep quality in older adults: a comparison using subjective and objective methods. Front Aging Neurosci 2015;7:166.
25. Chen D, Yin Z, Fang B. Measurements and status of sleep quality in patients with cancers. Support Care Cancer 2018;26(2):405-414.
26. Sharif MM, BaHammam AS. Sleep estimation using BodyMedia's SenseWear™ armband in patients with obstructive sleep apnea. Ann Thorac Med 2013;8(1):53-57.
27. Roane BM et al. Estimating sleep from multisensory armband measurements: validity and reliability in teens. J Sleep Res, 2015;24(6):714-21.
28. Sharif MM, Bahammam AS. Sleep estimation using BodyMedia's SenseWear armband in patients with obstructive sleep apnea. Ann Thorac Med 2013;8(1):53-7.
29. Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, Hazen N, Herman J, Katz ES, Kheirandish-Gozal L, Neubauer DN, O'Donnell AE, Ohayon M, Peever J, Rawding R, Sachdeva RC, Setters B, Vitiello MV, Ware JC, Adams Hillard PJ. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health 2015; 1(1): 40-43.
30. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193-213.
31. Ağargün M, Kara H, Anlar O. Pittsburgh uyku kalitesi indeksinin geçerliği ve güvenirliği. Türk Psikiyatri Dergisi 1996;7(2): 107-115.
32. Rakıcıoğlu N, Acar Tek N, Ayaz A, Pekcan G.Yemek ve Besin Fotoğraf Kataloğu Ölçü ve Miktarlar. 2 ed. Ankara: Ata Ofset Matbaacılık; 2009.
33. BeBiS, Nutrition Data Base Software Data Base Version 7. The German Food Code and Nutrient Data Base (BLS II.3, 1999) with additions from UDSA-sr and other sources; 2004.
34. SPSS, Statistical Package for the Social Sciences. Chicago, IL; USA; 2011.
35. Magee CA, Iverson DC, Huang XF, Caputi P. A link between chronic sleep restriction and obesity: methodological considerations. Public health 2008; 122(12):1373-1381.
36. Nagai M, Tomata Y, Watanabe T, Kakizaki M, Tsuji I. Association between sleep duration, weight gain, and obesity for long period. Sleep Med 2013;14(2):206-210.
37. Gonnissen HK, Adam TC, Hursel R, Rutters F, Verhoef SP, Westerterp-Plantenga MS. Sleep duration, sleep quality and body weight: Parallel developments. Physiol Behav 2013;121:112-116.
38. Kahlhöfer J, Karschin J, Breusing N, Bosy-Westphal A. Relationship between actigraphy‐assessed sleep quality and fat mass in college students. Obesity 2016;24(2): 335-341.
39. Rahe C, Czira ME, Teismann H, Berger K. Associations between poor sleep quality and different measures of obesity. Sleep Med 2015;16(10):1225-1228.
40. Lyytikäinen P, Lallukka T, Lahelma E, Rahkonen O. Sleep problems and major weight gain: a follow-up study. Int J Obes 2011;35(1):109-114.
41. Wirth MD, Hébert JR, Hand GA, Youngstedt SD, Hurley TG, Shook RP, Paluch AE, Sui X, James SL, Blair SN. Association between actigraphic sleep metrics and body composition. Ann Epidemiol 2015;25(10):773-778.
42. Kische H, Ewert R, Fietze I, Gross S, Wallaschofski H, Völzke H, Dörr M, Nauck M, Obst A, Stubbe B, Penzel T, Haring R. Sex hormones and sleep in men and women from the general population: a cross-sectional observational study. J Clin Endocrinol Metab 2016; 101(11):3968-3977.
43. Lord C, Sekerovic Z, Carrier J. Sleep regulation and sex hormones exposure in men and women across adulthood. Pathol Biol 2014;62(5):302-310.
44. Mong JA, Cusmano DM. Sex differences in sleep: impact of biological sex and sex steroids. Philos Trans R Soc Lond B Biol 2016;371(1688):20150110.
45. Chaput JP, Sjödin AM, Astrup A, Després JP, Bouchard C, Tremblay A.Risk factors for adult overweight and obesity: the importance of looking beyond the ‘big two’. Obes Facts 2010; 3(5):320-327.
46. Weiss A, Xu F, Storfer-Isser A, Thomas A, Ievers-Landis CE, Redline S. The association of sleep duration with adolescents’ fat and carbohydrate consumption. Sleep 2010;33(9):1201-1209.
47. Grandner MA, Kripke DF, Naidoo N, Langer RD. Relationships among dietary nutrients and subjective sleep, objective sleep, and napping in women. Sleep Med 2010;11(2):180-184.
48. Peuhkuri K, Sihvola N, Korpela R. Diet promotes sleep duration and quality. Nutr Res 2012; 32(5):309-19.
49. Roane BM, Van Reen E, Hart CN, Wing R, Carskadon MA. Estimating sleep from multisensory armband measurements: validity and reliability in teens. J Sleep Res 2015; 24(6):714-721.
50. Alsaadi SM, McAuley JH, Hush JM, Bartlett DJ, McKeough ZM, Grunstein RR, Dungan GC, Maher CG. Assessing sleep disturbance in low back pain: the validity of portable instruments. PloS one 2014;9(4):95824.
51. Osonoi Y, Mita T, Osonoi T, Saito M, Tamasawa A, Nakayama S, Someya Y, Ishida H, Kanazawa A, Gosho M, Fujitani Y, Watada H. Poor sleep quality is associated with increased arterial stiffness in Japanese patients with type 2 diabetes mellitus. BMC Endocr Disord 2015;(18):15-29.
52. Javaheri S, Storfer-Isser A, Rosen CL, Redline S. Sleep quality and elevated blood pressure in adolescents. Circulation 2008;118(10): 1034-1040.
53. Yaggi HK, Araujo AB, McKinlay JB. Sleep duration as a risk factor for the development of type 2 diabetes. Diabetes care 2006; 29(3): 657-661.
54. Okubo N, Matsuzaka M, Takahashi I, Sawada K, Sato S, Akimoto N, Umeda T, Nakaji S.Relationship between self-reported sleep quality and metabolic syndrome in general population. BMC Public Health 2014;14(1):1.