Sleep fragmentation and the risk of obesity: The Sleep Heart Health Study

Abstract Objective Sleep disturbances have been recognized as a risk factor for obesity. This study used polysomnography records to investigate associations between sleep fragmentation and obesity. Methods Objectively measured sleep fragmentation data recorded by in‐home polysomnography, including total arousal index (ArI‐total), ArI in rapid eye movement (REM) sleep (ArI‐REM), ArI in non‐REM sleep (ArI‐NREM), sleep fragmentation index, sleep efficiency (SE), and wake after sleep onset (WASO), were based on the Sleep Heart Health Study (2,835 men and 2,888 women with a mean [SD] age of 63.2 [11.2] years). Multivariable regression analyses were used to examine the relationship between sleep fragmentation and obesity. Results Multinomial logistic regression showed that participants with obesity have a significantly higher ArI‐total (odds ratio [OR] 1.018; 95% CI: 1.010‐1.026, p < 0.001), ArI‐REM (OR 1.010; 95% CI: 1.002‐1.018, p = 0.009), ArI‐NREM (OR 1.017; 95% CI: 1.009‐1.024, p < 0.001), and WASO (OR 1.003; 95% CI: 1.001‐1.005, p = 0.007) compared with those with normal weight. Furthermore, multiple linear regression analyses showed an obvious correlation between ArI‐total, ArI‐REM, ArI‐NREM, SE, WASO, and BMI. Conclusions The results revealed that ArI‐total, ArI‐REM, ArI‐NREM, SE, and WASO were associated with obesity. The improvement of sleep fragmentation may contribute to decreasing the risk of obesity.