ความสัมพันธ์ระหว่างคะแนนพฤติกรรมสุขภาพด้านการนอนหลับกับดัชนีมวลกาย และภาวะอ้วนในผู้รับบริการวัยทำงาน คลินิกเวชศาสตร์วิถีชีวิต ศูนย์อนามัยที่ 5 ราชบุรี

chatchawin wangvarunyoo

Authors

chatchawin wangvarunyoo Mahachai 2

Keywords:

sleep health behavior score, body mass index, obesity, working-age adults, lifestyle medicine

Abstract

Objective: To examine the relationship between sleep health behavior scores and body mass index (BMI) and obesity among working-age adults at the Lifestyle Medicine Clinic, Health Promotion Center Region 5, Ratchaburi

Methods: A retrospective analytic study was conducted among 170 working-age clients aged 18–59 years. Data were obtained from electronic medical records (sex, age, weight, height, and body mass index) and the Lifestyle Medicine Clinic’s health behavior assessment database (sleep, physical activity, dietary behavior, smoking, alcohol consumption, and comorbidities). The sample size was determined using the criterion of 10 observations per independent variable. Data were analyzed using descriptive statistics, the Pearson correlation coefficient, univariable binary logistic regression, and multivariable binary logistic regression (enter method). Statistical significance was set at p < .05.

Results: Most participants were female (64.7%); a mean age was 45.97 ± 10.33 years with a mean BMI of 27.73 ± 6.49 kg/m²; 60.6% were classified as obese (BMI ≥25.0 kg/m², Asian-Pacific criteria). There were 46.5% of participants who slept fewer than 7 hours per night. The mean sleep duration score was 2.91 ± 2.74 and the mean sleep quality score was 2.29 ± 1.65. Sleep behavior scores were significantly and inversely correlated with BMI: sleep duration score (r = −0.237; p = .002) and sleep quality score (r = −0.269; p < .001). In the multivariable binary logistic regression model (enter method), after adjusting for age, sleep duration score, resistance exercise, aerobic exercise, sedentary time, diabetes mellitus, and dyslipidemia, a one-point increase in the sleep quality score was independently associated with lower odds of obesity (adjusted OR = 0.66; 95% CI = 0.50–0.86; p = .002), as were age (adjusted OR = 0.96; 95% CI = 0.91–1.00; p = .036) and aerobic exercise (adjusted OR = 0.61; 95% CI = 0.43–0.87; p = .006), whereas diabetes mellitus was associated with higher odds of obesity (adjusted OR = 6.10; 95% CI = 1.47–25.35; p = .013).

Conclusion: Sleep quality score was inversely and independently associated with both BMI and obesity after adjustment for age, physical activity, and comorbidities. Because of the cross-sectional design, causal inference cannot be drawn. These findings support incorporating sleep quality assessment into routine evaluation at lifestyle medicine clinics, alongside physical activity and comorbidity assessment.

References

World Health Organization. Obesity and overweight [internet]. 2024 [cited 2026 Jan 28]; Available from: URL: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

สถาบันวิจัยและประเมินเทคโนโลยีทางการแพทย์ กรมการแพทย์ กระทรวงสาธารณสุข. แนวทางเวชปฏิบัติการป้องกันและดูแลรักษาโรคอ้วน. กรุงเทพมหานคร: สถาบันวิจัยและประเมินเทคโนโลยีทางการแพทย์; 2553.

Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med. 2011;364(25):2392–404. doi: 10.1056/NEJMoa1014296.

Sharma S, Kavuru M. Sleep and metabolism: an overview. Int J Endocrinol. 2010;2010:270832. doi: 10.1155/2010/270832.

Direksunthorn T. Sleep and cardiometabolic health: A narrative review of epidemiological evidence, mechanisms, and interventions. Int J Gen Med. 2025;18:5831–43. doi: 10.2147/IJGM.S563616.

Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1(3):e62. doi: 10.1371/journal.pmed.0010062.

Rihm JS, Menz MM, Schultz H, Bruder L, Schilbach L, Schmid SM, et al. Sleep deprivation selectively upregulates an amygdala-hypothalamic circuit involved in food reward. J Neurosci. 2019;39(5):888–99. doi: 10.1523/JNEUROSCI.0250-18.2018.

Yiengprugsawan V, Banwell C, Seubsman SA, Sleigh AC; Thai Cohort Study Team. Short sleep and obesity in a large national cohort of Thai adults. BMJ Open. 2012;2(1):e000561. doi: 10.1136/bmjopen-2011-000561.

Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB. Association between reduced sleep and weight gain in women. Am J Epidemiol. 2006;164(10):947–54. doi: 10.1093/aje/kwj280

Knutson KL, Spiegel K, Penev P, Van Cauter E. The metabolic consequences of sleep deprivation. Sleep Med Rev. 2007;11(3):163–78. doi: 10.1016/j.smrv.2007.01.002.

Magee CA, Huang XF, Iverson DC, Caputi P. Examining the pathways linking chronic sleep restriction to obesity. J Obes. 2010;2010:821710. doi: 10.1155/2010/821710.

Papatriantafyllou E, Efthymiou D, Zoumbaneas E, Popescu CA, Vassilopoulou E. Sleep deprivation: Effects on weight loss and weight loss maintenance. Nutrients. 2022;14(8):1549. doi: 10.3390/nu14081549.

Bui PTM, Van Nguyen T, Nguyen TQ, Nguyen CD, Nguyen BV, Hoang AM, et al. Exploring the relationship between sleep quality, obesity, and biochemical markers in elderly outpatients. Am J Hum Biol. 2025;37(5):e70056. doi: 10.1002/ajhb.70056.

Rippe JM. Lifestyle medicine: The health promoting power of daily habits and practices. Am J Lifestyle Med. 2018;12(6):499–512. doi: 10.1177/1559827618785554.

โรงพยาบาลศูนย์อนามัยที่ 5 ราชบุรี. คลินิกเวชศาสตร์วิถีชีวิต (Lifestyle Medicine) [อินเทอร์เน็ต]. [เข้าถึงเมื่อ 28 มกราคม พ.ศ. 2569]; เข้าถึงได้จาก: URL: https://hospital.hpc5.go.th/home/

กรมอนามัย กระทรวงสาธารณสุข. แบบประเมินพฤติกรรมสุขภาพ เวชศาสตร์วิถีชีวิต [อินเทอร์เน็ต]. [เข้าถึงเมื่อ 28 มกราคม 2569]; เข้าถึงได้จาก: URL: https://mwi.anamai.moph.go.th/.

Kline CE, Chasens ER, Bizhanova Z, Sereika SM, Buxton OM, Imes CC, et al. The association between sleep health and weight change during a 12-month behavioral weight loss intervention. Int J Obes (Lond). 2021;45(3):639–49. doi: 10.1038/s41366-020-00728-8.

Quick V, Byrd-Bredbenner C, White AA, Brown O, Colby S, Shoenfelt J, et al. Eat, sleep, work, play: Associations of weight status and health-related behaviors among young adult college students. Am J Health Promot. 2014;29(2):e64–72. doi: 10.4278/ajhp.130327-QUAN-130.

Xu Q, Lin Z, Chen Y, Huang M. Association between sleep duration and patterns and obesity: A cross-sectional study of the 2007–2018 national health and nutrition examination survey. BMC Public Health. 2025;25:1460. doi: 10.1186/s12889-025-22433-9

Xie YJ, Loke AY, Cheung DSK, Lam Nogueira BOC, Liu K, Leung A, et al. Associations of sleep quality with body mass index and obesity: The health needs assessment study of Macao residents [Abstract P390]. Circulation. 2020;141(Suppl 1):AP390. doi: 10.1161/circ.141.suppl_1.P390

Hawkins MS, Pokutnaya DY, Duan D, Coughlin JW, Martin LM, Zhao D, et al. Associations between sleep health and obesity and weight change in adults: The Daily24 Multisite Cohort Study. Sleep Health. 2023;9(5):767–73. doi: 10.1016/j.sleh.2023.03.006.

Cohen J, Cohen P. Applied multiple regression/correlation analysis for the behavioral sciences. 2nd ed. Hillsdale (NJ): Lawrence Erlbaum Associates; 1984.