Many of us in Singapore might be familiar with the fact that our sleep quality is poor. Asian populations tend to report shorter sleep durations compared to other groups, which raises concerns about whether inadequate or poor-quality sleep might be contributing to the increasing rates of obesity in Asia. What were the results of a recent Singaporean study reviewing sleep duration and weight (obesity)?
As ever, please talk to your doctor, or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle; especially if you are under treatment. We provide links to relevant studies at bottom of page.
The study aimed to explore the links between sleep duration, sleep quality and habits like dozing and daytime napping, snoring, insomnia and body fat levels in a multi-ethnic Asian population. Here are some of the key findings from the study:
"In the present study, we show an independent relationship between adiposity and key indicators of sleep duration and quality. Our results suggest that sleep disturbances may make an important contribution to the increased risk of obesity in Asian populations.
We also show a high prevalence of reduced sleep duration and sleep quality in our participants, and that both sleep duration and sleep quality are strongly and inversely associated with measures of adiposity.
Notably, sleep duration and quality are reduced in both Malay and Indians compared to Chinese. Our results suggest that poor sleep may be an important contributor to the rising burden of adiposity in Asian populations, and further suggest that improving sleep duration and quality could mitigate obesity rates through targeted public health interventions."
51.0% of the population was reporting symptoms of either insomnia (36.7%), dozing (1.4%), daytime napping (16.2%), snoring (11.6%) or a combination of these symptoms (12.9%).
There were still 38.7% of Chinese considered as poor sleepers (Pittsburgh Sleep Quality Index > 5) with Malays and Indians having higher proportions at 52.1% and 52.0%,
Obesity prevalence (based on BMI ≥ 30) was 6.1% for Chinese, 29.5% for Malays and 23.6% for Indians.
Even after accounting for sleep habits like duration, quality, insomnia, and snoring, ethnicity still played a significant role in predicting body fat levels. Learn more about sleep duration and its impact on health, here.
This finding means that the higher rates of obesity in Malay and Indian individuals in Singapore can't be fully explained by differences in sleep. Other factors, like genetics and lifestyle, may also be contributing. For instance, genetic variations linked to body weight differ between ethnic groups. This also has an impact on Singaporean's diabetes risk.
The study suggests that improving sleep could have a notable impact on obesity. If poor sleep directly causes weight gain, better sleep habits might prevent around 6.6% of obesity cases overall, with an even greater impact for Malays and Indians, who typically sleep less.
Similarly, addressing snoring could prevent up to 19% of obesity if it is confirmed as a cause, as other studies suggest.
Final Thoughts
The study showed an independent relationship between being overweight and key indicators of sleep duration and quality.
In our own practice we see that addressing sleep problems can also address problems with eating patterns and energy levels; sleep is intertwined with multiple aspects of health and lifestyle. So addressing and improving one area of health can also support change - improvement - in other areas. Understanding where to start is useful. Learn more about the pillars of health and see what resonates with you.
For most people, improving sleep, health, is about finding motivation and prioritising self-care with an ultimate goal of taking action. If you want to take effective and targeted steps that fit into your unique lifestyle, The Whole Health Practice is here to help.
Whether your interest is sleep and longevity, to beat chronic illness or to enhance your mental health and well-being, our consultations and programs deliver results that are tailored to your needs.
Our foundational Whole Health Consult identifies and prioritises the key factors - known and unknown - that affect health and wellbeing. It provides targeted recommendations tailored to you, the individual, and your unique lifestyle.
Stay Healthy,
Alastair
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Related Studies
The study in question... Lam, C.C.B., Mina, T., Xie, W. et al. The relationships between sleep and adiposity amongst multi-ethnic Asian populations: a cross-sectional analysis of the Health for Life in Singapore (HELIOS) study. Int J Obes (2024). https://doi.org/10.1038/s41366-024-01666-5
Li H, Qian F, Han L, Feng W, Zheng D, Guo X, Zhang H. Association of Healthy Sleep Patterns with Risk of Mortality and Life Expectancy at Age 30 Years: A Population-Based Cohort Study. QJM. 2023 Oct 13:hcad237. doi: 10.1093/qjmed/hcad237. Epub ahead of print. PMID: 37831896.
Windred DP, Burns AC, Lane JM, Saxena R, Rutter MK, Cain SW, Phillips AJK. Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort study. Sleep. 2024 Jan 11;47(1):zsad253. doi: 10.1093/sleep/zsad253. PMID: 37738616; PMCID: PMC10782501.
Liang YY, Feng H, Chen Y, Jin X, Xue H, Zhou M, Ma H, Ai S, Wing YK, Geng Q, Zhang J. Joint association of physical activity and sleep duration with risk of all-cause and cause-specific mortality: a population-based cohort study using accelerometry. Eur J Prev Cardiol. 2023 Jul 12;30(9):832-843. doi: 10.1093/eurjpc/zwad060. PMID: 36990109.
Kocevska D, Lysen TS, Dotinga A, Koopman-Verhoeff ME, Luijk MPCM, Antypa N, Biermasz NR, Blokstra A, Brug J, Burk WJ, Comijs HC, Corpeleijn E, Dashti HS, de Bruin EJ, de Graaf R, Derks IPM, Dewald-Kaufmann JF, Elders PJM, Gemke RJBJ, Grievink L, Hale L, Hartman CA, Heijnen CJ, Huisman M, Huss A, Ikram MA, Jones SE, Velderman MK, Koning M, Meijer AM, Meijer K, Noordam R, Oldehinkel AJ, Groeniger JO, Penninx BWJH, Picavet HSJ, Pieters S, Reijneveld SA, Reitz E, Renders CM, Rodenburg G, Rutters F, Smith MC, Singh AS, Snijder MB, Stronks K, Ten Have M, Twisk JWR, Van de Mheen D, van der Ende J, van der Heijden KB, van der Velden PG, van Lenthe FJ, van Litsenburg RRL, van Oostrom SH, van Schalkwijk FJ, Sheehan CM, Verheij RA, Verhulst FC, Vermeulen MCM, Vermeulen RCH, Verschuren WMM, Vrijkotte TGM, Wijga AH, Willemen AM, Ter Wolbeek M, Wood AR, Xerxa Y, Bramer WM, Franco OH, Luik AI, Van Someren EJW, Tiemeier H. Sleep characteristics across the lifespan in 1.1 million people from the Netherlands, United Kingdom and United States: a systematic review and meta-analysis. Nat Hum Behav. 2021 Jan;5(1):113-122. doi: 10.1038/s41562-020-00965-x. Epub 2020 Nov 16. PMID: 33199855.
Other Singapore Studies
Svensson T, Saito E, Svensson AK, Melander O, Orho-Melander M, Mimura M, Rahman S, Sawada N, Koh WP, Shu XO, Tsuji I, Kanemura S, Park SK, Nagata C, Tsugane S, Cai H, Yuan JM, Matsuyama S, Sugawara Y, Wada K, Yoo KY, Chia KS, Boffetta P, Ahsan H, Zheng W, Kang D, Potter JD, Inoue M. Association of Sleep Duration With All- and Major-Cause Mortality Among Adults in Japan, China, Singapore, and Korea. JAMA Netw Open. 2021 Sep 1;4(9):e2122837. doi: 10.1001/jamanetworkopen.2021.22837. PMID: 34477853; PMCID: PMC8417759.
Visvalingam N, Sathish T, Soljak M, Chua AP, Dunleavy G, Divakar U, Nazeha N, Bajpai R, Soh CK, Woon KK, Christopoulos G, Car J. Prevalence of and factors associated with poor sleep quality and short sleep in a working population in Singapore. Sleep Health. 2020 Jun;6(3):277-287. doi: 10.1016/j.sleh.2019.10.008. Epub 2019 Dec 11. PMID: 31836498.
Lee YY, Lau JH, Vaingankar JA, Sambasivam R, Shafie S, Chua BY, Chow WL, Abdin E, Subramaniam M. Sleep quality of Singapore residents: findings from the 2016 Singapore mental health study. Sleep Med X. 2022 Jan 28;4:100043. doi: 10.1016/j.sleepx.2022.100043. PMID: 35243325; PMCID: PMC8861160.
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