Abstract

Sleep characteristics have been associated with body mass index (BMI) among adolescents, but population-representative evidence on sleep timing and variation across demographic subgroups remains limited. We conducted a cross-sectional analysis of 2017–2018 California Health Interview Survey data from 880 adolescents aged 12–17 years. Weeknight sleep duration was obtained from the CHIS-derived sleep-duration variable, based on reported school-night bedtimes and school-day wake times. Sleep-timing measures included bedtime, wake time, and the derived sleep midpoint. Pooled survey-weighted linear and logistic regression models used 160 jackknife replicate weights and adjusted for age, sex, race/ethnicity, household poverty category, and survey year; sensitivity models additionally adjusted for dietary and behavioral factors. Sleep duration was not associated with BMI overall (p = 0.161) or with the odds of having overweight or obesity (p = 0.36). The association between sleep duration and BMI varied by age group (p for interaction = 0.042). Each additional hour of sleep was associated with a lower BMI among adolescents aged 14–17 years (β = −0.895 kg/m2; 95% CI: −1.464 to −0.326; p = 0.002), but not among those aged 12–13 years. However, there was no evidence of an interaction when age was modeled continuously (p for interaction = 0.36). Bedtime, wake time, and sleep midpoint were not independently associated with BMI. Exploratory evidence that the association between sleep duration and overweight or obesity varied by race/ethnicity was attenuated after adjustment for dietary and behavioral factors (p for interaction changed from 0.04 to 0.05). In this cross-sectional study, neither sleep duration nor sleep timing was associated with BMI in the overall sample, and sleep duration was not associated with BMI-defined weight status. Subgroup findings were not consistent across model specifications and should be examined in longitudinal studies using objective and repeated measures of sleep.

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