Table 1.
Studies included in the meta-analysis
| First author and year of publi- cation | Country | Population | Follow- up time | Age range | Sex | Sam- ple size | Body mass index | Sleep-related issues | Quality assessment: Risk of bias | Results | Adjustment for other covariates | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Selection | Confounders | Performance blas |
Data collection method |
Withdrawals and dropouts | |||||||||||||||||||||||||||
| Batool- Anwar, 2016 | USA | General population | 6 years | 25-75 | 76.04% | 55,540 | Self- report- ed | International Restless Legs Study Group criteria (restless legs syndrome) | Low | Low | Mode- rate | Low | Low | Odd ratio; reference (BMI < 23) Men: 1. Overweight, BMI: 25–26.9; 1.41 (CI: 1.00-1.97); BMI: 27–29.9; 1.54 (CI 1.10- 2.20); 2. Obesity, BMI > 30; 1.46 (CI: 0.96-2.20) Women: 1. Overweight, BMI: 25–26.9; 1.12 (CI: 0.91-1.38); BMI: 27–29.9; 1.66 (CI: 1.37-2.01); 2. Obesity, > 30; 1.64 (CI: 1.37-1.96) Pooled BMI ≥ 25: 1.48 (CI: 1.34-1.63) Pooled overweight: 1.41 (CI: 1.25-1.59) Pooled obesity: 1.61 (CI: 1.37-1.90) Pooled BMI ≥ 25 for men: 1.47 (CI: 1.19-1.81) Pooled BMI ≥ 25 for women: 1.48 (CI: 1.32-1.65) |
Race, the Crown- Crisp anxiety score, antidepressant medication, use of iron specific sup- plement at base- line, menopausal status, chronic illnesses |
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| Boulou- kaki, 2011 | Greek | General population | 6 years | 50.7 ± 12.2 |
23.4% women |
2,690 | Mea- sured | Apnea + hypo- pnea index (obstructive sleep apnea) | Low | High | Low | Low | Low | Odd ratio Total*: 5.08 (CI: 4.37-5.91) Men: 6.86 (CI: 5.74-8.19) Women: 4.09 (CI: 3.01-5.54) |
Unadjusted | ||||||||||||||||
| Chan, 2016 | China | Coronary artery disease | 3 years | > 21 | 9% women |
587 | Mea- sured | Apnoea-hy- popnea index (obstructive sleep apnea) | Mode- rate | High | Low | Low | Low | Odd ratio Reference: 1.11 (CI: 1.06-1.17) | Smoking, hypertension | ||||||||||||||||
| Chen, 2017 | Taiwan | General population | 7 years | ≥ 18 | 46.6% women |
12,728 | Un- known | Clinically diagnosed (insomnia) | Low | Mode- rate | Mode- rate | Low | Low | Hazard ratio Reference (BMI: 18.5-23.9) Overweight, BMI 24-26.9: 0.87 (CI: 0.73-1.03) Obesity, BMI ≥ 27: 0.99 (CI: 0.82-1.19) Pooled BMI ≥ 25: 0.92 (CI: 0.81-1.05) |
Multivariate adjustment | ||||||||||||||||
| Elomaa, 2013 | Finland | History of depres- sive symp- toms |
7 years | 25-64 | 66.1% women |
127 | Mea- sured | Self-reported (sleep distur- bance) | High | High | Low | High | High | Odd ratio Reference (without reference): 0.92 (CI: 0.84-1.00) |
Smoking, use of sleep or lipidlowering medication | ||||||||||||||||
| Gureje, 2011 | Nigeria | Elderly | 1 year | ≥ 65 | 50.5% women |
1,307 | Mea- sured | World Health Organization Composite International Diagnostic Interview (insomnia) | Low | High | Low | Mode- rate | Mode- rate | Odd ratio Reference: BMI < 18.5 Overweight, BMI 25.0-29.9: 0.90 (CI: 0.30-2.70) Obesity, BMI ≥ 30: 1.70 (CI: 0.50-6.00) Pooled BMI ≥ 25: 1.19 (CI: 0.52-2.71) |
Sex, age | ||||||||||||||||
| Janson, 2001 | Sweden | General population | 10 years | 30-69 | Men | 2,602 | Self- report- ed | Questionnaire (insomnia) | Mode- rate | Mode- rate | Mode- rate | Mode- rate | Mode- rate | Odd ratio Reference (BMI < 27) BMI > 27: 1.35 (CI: 1.01-1.81) |
Medical disorder, BMI, physically inactive, alcohol dependent | ||||||||||||||||
| Jaussent 2011 | France | Older adults | Un- known | ≥ 65 | 54.6% women |
5,886 | Self- report- ed | Questionnaire (sleep complaints) (insomnia) | Low | Mode- rate | Mode- rate | Mode- rate | Low | Odd ratio Reference: BMI < 25 Difficulty with initiating sleep Men: Overweight, BMI 25-29: 1.00 (CI: 0.51-1.96); Obesity, BMI > 30: 2.70 (CI: 1.15-6.34) Women: Overweight, BMI 25-29: 0.91 (CI: 0.61- 1.37); Obesity, BMI > 30: 0.57 (CI: 0.30-1.07) Pooled BMI ≥ 25: 0.95 (CI: 0.71-1.27) Pooled overweight: 0.93 (CI: 0.66-1.32) Pooled obesity: 0.99 (CI: 0.60-1.65) Pooled BMI ≥ 25 for men: 1.46 (CI: 0.86-2.48) Pooled BMI ≥ 25 for women: 0.80 (CI: 0.57-1.12) |
Multivariate | ||||||||||||||||
| Kim, 2004 | Korea | Middle- aged | Un- known | 40-69 | 32.3% women |
457 | Un- known | Apnea- hypopnea index (obstructive sleep apnea) | High | High | Mode- rate | Low | High | Odd ratio Reference: 3.96 (CI: 2.27-6.91) | Age, sex, hypertension | ||||||||||||||||
| Knuiman, 2006 | Austra- lia | General population | 14 years | 25-74 | 63% women |
967 | Mea- sured | Questionnaire (snoring) | Low | Mode- rate | Low | Mode- rate | Low | Odd ratio Reference: 1.44 (CI: 1.18-1.75) | Multivariate- adjusted | ||||||||||||||||
| Mokhlesi, 2012 | USA | Polycystic ovary syn- drome | Un- known | 18-40 | Women | 78 | Un- known | Berlin questionnaire (obstructive sleep apnea) | High | High | Mode- rate | Mode- rate | High | Odd ratio 1.23 (CI: 1.11-1.36) | Unknown | ||||||||||||||||
| Morgan, 2003 | UK | Elderly | 8 years | Unknown | Both | 410 | Un- known | Interview assessments (insomnia) | Mode- med | Mode- med | Mode- med | High | High | Odd ratio BMI > 25: 0.80 (CI: 0.50-1.40) |
Adjusted | ||||||||||||||||
| Pedraza, 2012 | USA | Elderly | 3 years | ≥ 75 | 62% women |
1,085 | Mea- sured | Self-reported (sleep complaints, poor sleep quality) | Low | Low | Low | Mode- rate | Low | Odd ratio; reference (BMI < 25) Trouble Falling Asleep: Overweight, BMI 25 < 30: 1.14 (CI: 0.72-1.81); Obesity, BMI 30 > 35: 1.11 (CI: 0.65-1.90); Over obesity, BMI ≥ 35: 1.73 (CI: 0.86-3.45) Wake up several times per night: Overweight, BMI 25 < 30: 1.11 (CI: 0.80-1.54); Obesity, BMI 30 > 35: 1.51 (CI: 1.03-2.21); Over obesity, BMI ≥ 35: 2.33 (CI: 1.37-3.96) Trouble Staying Asleep: Overweight, BMI 25 < 30: 1.02 (CI: 0.63-1.69); Obesity, BMI 30 > 35: 1.57 (CI: 0.92-2.68); Over obesity, BMI ≥ 35: 1.20 (CI: 0.55-2.62) Wake up after your usual amount of sleep. Feeling tired and worn: Overweight, BMI 25 < 30: 1.28 (CI: 0.73-2.22); Obesity, BMI 30 > 35: 1.58 (CI: 0.86-2.91); Over obesity, BMI ≥ 35: 1.91 (CI: 0.86-2.24) Poor quality of sleep: Overweight, BMI 25 < 30: 0.93 (CI: 0.61-1.41); Obesity, BMI 30 > 35: 1.25 (CI: 0.79-1.99); Over obesity, BMI ≥ 35: 1.20 (CI: 0.62-2.32) Pooled BMI ≥ 25: 1.32 (CI: 0.95-1.83) Pooled overweight: 1.53 (CI: 0.82-2.84) Pooled obesity: 1.16 (CI: 0.70-1.92) |
Baseline socio- demographics, medical conditions, high depressive symptoms, cognitive impairment and ADL disability |
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| Phillips 2005 | USA | General popu- lation | 9 years | 45-69 | 55.2% women |
13,564 | Un- known | Maastricht Questionnaire (sleep complaints) | Low | Low | Mode- rate | Mode- rate | Low | Odd ratio Reference: BMI 20-24 Difficulty falling asleep: Overweight, BMI 25-29: 0.80 (CI: 0.80-1.00); Obesity, BMI ≥ 30: 0.90 (CI: 0.80-1.01) Sleep continuity disturbance: Overweight, BMI 25-29: 1.00 (CI: 0.90-1.10); Obesity, BMI ≥30: 1.10 (CI: 0.96-1.20) Non-restorative sleep: Overweight, BMI 25-29: 1.00 (CI: 0.90-1.10); Obesity, BMI ≥ 30: 1.00 (CI: 0.90-1.10) Pooled BMI ≥ 25: 0.97 (CI: 0.88-1.07) Pooled overweight: 0.93 (CI: 0.80-1.08) Pooled obesity: 1.00 (CI: 0.88-1.12) |
Age, sex, meno- pausal status, race, education level, income, body mass index, depres- sion, presence of cardiac disease, lung function status, presence of hypertension, alcohol intake, diabetes, and hypnotic use | ||||||||||||||||
| Quan, 2005 | USA | Elderly | 4 years | ≥ 65 | Both | 4,467 | Mea- sured | Questionnaire (excessive daytime sleepiness) | Low | Mode- rate | Low | Mode- rate | Low | Odd ratio Reference: 1.03 (CI: 1.01-1.05) | Age, sex, race, time interval between exami- nations | ||||||||||||||||
| Singa- reddy, 2012 | USA | General population | 7.5 years | ≥ 20 | 47.6% women |
1,741 | Self- report- ed | Self-reported (Insomnia) | Low | Low | Mode- rate | Mode- rate | Low | Odd ratio Obesity: 1.24 (CI: 0.80-1.93) | Age, gender, obesity, race, cigarettes, alcohol, caffeine use, physical health problems, mental health problems, poor sleep | ||||||||||||||||
| Skarp- snno, 2018 | Norway | General population | 11 years | ≥ 20 | 54.5% women |
21,847 | Mea- sured | Self-reported (Insomnia) | Low | Low | Low | Mode- rate | Low | Risk ratio; reference (normal BMI) Men: Overweight: 1.22 (CI: 0.97-1.53), Obesity: 1.48 (CI: 1.08-2.01) Women: Overweight: 1.15 (CI: 0.97-1.35) Obesity: 1.25 (CI: 1.00-1.56) Odd ratio* Men: Overweight: 1.21 (CI: 0.97-1.50) Obesity: 1.45 (CI: 1.08-1.94) Women: Overweight: 1.14 (CI: 0.97-1.32) Obesity: 1.23 (CI: 1.00-1.51) Pooled BMI ≥ 25: 1.21 (CI: 1.09-1.34) Pooled overweight: 1.16 (CI: 1.03-1.32) Pooled obesity: 1.30 (CI: 1.10-1.54) Pooled BMI ≥ 25 for men: 1.29 (CI: 1.08-1.54) Pooled BMI ≥ 25 for women: 1.17 (CI: 1.04-1.33) |
Age, leisure time physical activity, education, smoking, shift work, alcohol consumption, HADS | ||||||||||||||||
| Theorell- Haglöw, 2015 | Sweden | General population | 10 years | 43.7 ± 15.2 |
Women | 7,051 | Self- report- ed | Uppsala Sleep Inventory; self-reported (excessive daytime sleepiness) |
Low | High | Mode- rate | Mode- rate | Low | Odd ratio Obesity, BMI ≥ 28: 1.28 (CI: 0.62-2.66) |
Age, development in all covariates, somatic disease | ||||||||||||||||
| Tom, 2010 | UK | General population | Unknown | 48-54 | Women | 962 | Un- known | Self-reported (sleep difficulty) | High | High | Mode- rate | High | Mode- rate | Odd ratio, reference (BMI < 18.5) Overweight, BMI 25-29.9: 1.52 (CI: 0.80-2.89) Obesity, BMI ≥ 30: 1.82 (CI: 0.91-2.66) Pooled BMI ≥ 25: 1.69 (CI: 1.12-2.55) |
Age | ||||||||||||||||
| Vahtera, 2009 | France | Retired employees | 7 years | 35-50 at base- line |
21% women |
14,714 | Self- report- ed | Questionnaires (sleep disturbances) | Low | High | Mode- rate | Mode- rate | Low | Odd ratio, reference (BMI ≤ 24.9) Overweight, BMI 25-29.9: 1.03 (CI: 0.96-1.11) Obesity, BMI ≥ 30: 1.10 (CI: 0.97-1.24) Pooled BMI ≥ 25: 1.05 (CI: 0.98-1.12) |
Sex, age | ||||||||||||||||
| Wilton, 2018 | USA | Rheuma- toid arthritis | ≥ 14.8 years |
≥ 18 | 68% women |
813 | Un- known | Medical record (obstructive sleep apnea) | Low | Mode- rate | Mode- rate | Low | Low | Hazard ratio 4.99 (CI: 2.98-8.36) | Age, sex, calendar year | ||||||||||||||||
*
Calculated by author(s)