Advertisement

Sleep quality as predictor of BMI in non-depressed caregivers of people with dementia

  • Stefano Eleuteri
  • Maria C. Norton
  • Federica Livi
  • Caterina Grano
  • Paolo Falaschi
  • Cristiano Violani
  • Fabio Lucidi
  • Caterina Lombardo
Original Article
  • 44 Downloads
Part of the following topical collections:
  1. Sleep and Obesity

Abstract

Purpose

Although most cross-sectional and longitudinal studies of children and adolescents have found a link between short duration of sleep and obesity, the literature related to adults provides a non-consensual framework. The aim of the present study was to examine the association between sleep quality and BMI in a population of caregivers looking after people suffering from dementia, with a view to identifying the moderating role of depressive symptoms in the relationship between sleep problems and BMI.

Methods

A total of 117 subjects took part in the study, filling in a Sociodemographic Questionnaire, the Pittsburgh Sleep Quality Index, the Eating behavior Questionnaire and The Center for Epidemiologic Studies-Depression.

Results

Depressive symptoms were greater in females than in males. The sample was divided into two subgroups based on depressive-symptom scores. Only within the subsample with low depressive symptoms, higher sleep disturbances influenced BMI positively. Within this subsample of participants with low depressive symptoms, the variables that seem to play a pivotal role in explaining a high BMI are: female gender, sleep problems, and diet quality, while within the subsample with high depressive symptoms only the female gender factor was found to influence BMI.

Conclusions

Depressive symptoms seem to act as moderators in the relationship between sleep and BMI. They should be evaluated to identify the risk of high BMI, and to differentiate clinical intervention, at least in this population, which experiences the stress of caregiving chronically, though not suffering from clinical eating disorders.

Level of evidence

Level II, cross-sectional study.

Keywords

Eating disorders Obesity Mediterranean diet Sleep quality Depression Caregiving 

Notes

Compliance with ethical standards

Conflict of interest

All the authors declare that they have no conflict of interest. The last-mentioned author is also the Editor of the Topical Collection where the manuscript is submitted.

Ethical approval

All the procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its successive amendments or comparable ethical standards. The study was approved by the Institutional Review Board of the Psychology Department, Sapienza University of Rome.

Informed consent

Informed consent was obtained individually from all the participants included in the study.

References

  1. 1.
    Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C (2015) Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy Of Sleep Medicine and Sleep Research Society. Sleep 38:843–844.  https://doi.org/10.5665/sleep.4716 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    National Sleep Foundation (2005) Summary of findings. https://sleepfoundation.org/sites/default/files/2005_summary_of_findings.pdf. Accessed 31 Jan 2018
  3. 3.
    Youngstedt SD, Goff EE, Reynolds AM, Kripke DF, Irwin MR, Bootzin RR, Khan N, Jean-Louis G (2016) Has adult sleep duration declined over the last 50+ years? Sleep Med Rev 28:69–85.  https://doi.org/10.1016/j.smrv.2015.08.004 CrossRefPubMedGoogle Scholar
  4. 4.
    Kohatsu ND, Tsai R, Young T, Vangilder R, Burmeister LF, Stromquist AM, Merchant JA (2006) Sleep duration and body mass index in a rural population. Arch Intern Med 166:1701–1705.  https://doi.org/10.1001/archinte.166.16.1701 CrossRefPubMedGoogle Scholar
  5. 5.
    Gottlieb DJ, Punjabi NM, Newman AB, Resnick HE, Redline S, Baldwin CM, Nieto FJ (2005) Association of sleep time with diabetes mellitus and impaired glucose tolerance. Arch Intern Med 165:863–867.  https://doi.org/10.1001/archinte.165.8.863 CrossRefPubMedGoogle Scholar
  6. 6.
    Chaput JP, Dutil C (2016) Lack of sleep as a contributor to obesity in adolescents: impacts on eating and activity behaviors. IJBNPA 13:103.  https://doi.org/10.1186/s12966-016-0428-0 PubMedGoogle Scholar
  7. 7.
    Pilcher JJ, Ginter DR, Sadowsky B (1997) Sleep quality versus sleep quantity: relationships between sleep and measures of health, well-being and sleepiness in college students. J Psychosom Res 42:583–596.  https://doi.org/10.1016/S0022-3999(97)00004-4 CrossRefPubMedGoogle Scholar
  8. 8.
    Chaput JP, Despres JP, Bouchard C, Tremblay A (2008) The association between sleep duration and weight gain in adults: a 6-year prospective study from the Quebec Family Study. Sleep 31:517–523CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Gooneratne NS, VitielloVM (2014) Normative changes, sleep disorders and treatment options. Clin Geriatr Med 30:591–627.  https://doi.org/10.1016/j.cger CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Beccuti G, Pannain S (2011) Sleep and obesity. Curr Opin Clin Nutr Metab Care 14:402–412.  https://doi.org/10.1097/MCO.0b013e3283479109 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Ohayon MM, Vecchierini MF (2005) Normative sleep data, cognitive function and daily living activities in older adults in the community. Sleep 28:981–989CrossRefPubMedGoogle Scholar
  12. 12.
    Gildner TE, Liebert MA, Kowal P, Chatterji S, Josh Snodgrass J (2014) Sleep duration, sleep quality, and obesity risk among older adults from six middle-income countries: findings from the study on global ageing and adult health. Am J Hum Biol 26:803–812.  https://doi.org/10.1002/ajhb.22603 CrossRefPubMedGoogle Scholar
  13. 13.
    Magee CA, Caputi P, Iverson DC (2010) Is sleep duration associated with obesity in older Australian adults? J Aging Health 22:1235–1255.  https://doi.org/10.1177/0898264310372780 CrossRefPubMedGoogle Scholar
  14. 14.
    Norton MC, Eleuteri S, Cerolini S, Ballesio A, Conte SC, Falaschi P, Lucidi F (2017) Is poor sleep associated with obesity in older adults? A narrative review of the literature. Eat Weight Disord.  https://doi.org/10.1007/s40519-017-0453-2 PubMedGoogle Scholar
  15. 15.
    Lombardo C, Battagliese G, Venezia C, Salvemini V (2015) Persistence of poor sleep predicts the severity of the clinical condition after 6 months of standard treatment in patients with eating disorders. Eat Behav 18:16–19. https://doi.org/10.1016/j.eatbeh.2015.03.003 CrossRefPubMedGoogle Scholar
  16. 16.
    Zimmerman ME, Bigal ME, Katz MJ, Derby CA, Lipton RB (2013) Are sleep onset/maintenance difficulties associated with medical or psychiatric comorbidities in nondemented community-dwelling older adults? J Clin Sleep Med 9:363–369.  https://doi.org/10.5664/jcsm.2590 PubMedPubMedCentralGoogle Scholar
  17. 17.
    Vaatainen S, Tuomilehto H, Saramies J, Tuomilehto J, Uusitalo H, Hussi E, Keinanen-Kiukaanniemi S, Martikainen J (2013) The health-related quality-of-life impact of nocturnal awakenings in the middle-aged and older Finnish population. Qual Life Res 22:2737–2748.  https://doi.org/10.1007/s11136-013-0404-y CrossRefPubMedGoogle Scholar
  18. 18.
    Cross N, Terpening Z, Rogers NL, Duffy SL, Hickie IB, Lewis SJ, Naismith SL (2015) Napping in older people ‘at risk’ of dementia: relationships with depression, cognition, medical burden and sleep quality. J Sleep Res 24:494–502.  https://doi.org/10.1111/jsr.12313 CrossRefPubMedGoogle Scholar
  19. 19.
    Elder CR, Gullion CM, Funk KL, Debar LL, Lindberg NM, Stevens VJ (2012) Impact of sleep, screen time, depression and stress on weight change in the intensive weight loss phase of the LIFE study. Int J Obes 36:86–92.  https://doi.org/10.1038/ijo.2011.60 CrossRefGoogle Scholar
  20. 20.
    Knutson KL, Lauderdale DS (2007) Sleep duration and overweight in adolescents: self-reported sleep hours versus time diaries. Pediatrics 119:e1056–e1062.  https://doi.org/10.1542/peds.2006-2597 CrossRefPubMedGoogle Scholar
  21. 21.
    Jow GM, Yang TT, Chen CL (2006) Leptin and cholesterol levels are low in major depressive disorder, but high in schizophrenia. J Affect Disord 90:21–27.  https://doi.org/10.1016/j.jad.2005.09.015 CrossRefPubMedGoogle Scholar
  22. 22.
    Kraus T, Haack M, Schuld A, Hinze-Selch D, Pollmacher T (2001) Low leptin levels but normal body mass indices in patients with depression or schizophrenia. Neuroendocrinology 73:243–247.  https://doi.org/10.1159/000054641 CrossRefPubMedGoogle Scholar
  23. 23.
    Lu XY (2007) The leptin hypothesis of depression: a potential link between mood disorders and obesity? Curr Opin Pharmacol 7:648–652.  https://doi.org/10.1016/j.coph.2007.10.010 CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Sinton CM, Fitch TE, Gershenfeld HK (1999) The effects of leptin on REM sleep and slow wave delta in rats are reversed by food deprivation. J Sleep Res 8:197–203.  https://doi.org/10.1046/j.1365-2869.1999.00158.x CrossRefPubMedGoogle Scholar
  25. 25.
    Laposky AD, Shelton J, Bass J, Dugovic C, Perrino N, Turek FW (2006) Altered sleep regulation in leptin-deficient mice. Am J Physiol Regul Integr Comp Physiol 290:R894–R903.  https://doi.org/10.1152/ajpregu.00304.2005 CrossRefPubMedGoogle Scholar
  26. 26.
    Wojnar J, Brower KJ, Dopp R, Wojnar M, Emslie G, Rintelmann J, Hoffmann RF, Armitage R (2010) Sleep and body mass index in depressed children and healthy controls. Sleep Med 11:295–301.  https://doi.org/10.1016/j.sleep.2009.02.012 CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Grano C, Lucidi F, Violani C (2017) The relationship between caregiving self-efficacy and depressive symptoms in family caregivers of patients with Alzheimer disease: a longitudinal study. Int Psychogeriatr 29:1095–1103.  https://doi.org/10.1017/S1041610217000059 CrossRefPubMedGoogle Scholar
  28. 28.
    Cheng ST (2017) Dementia caregiver burden: a research update and critical analysis. Curr Psychiatry Rep 19:64.  https://doi.org/10.1007/s11920-017-0818-2 CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Brodaty H, Donkin M (2009) Family caregivers of people with dementia. Dialogues Clin Neurosci 11(2):217–228PubMedPubMedCentralGoogle Scholar
  30. 30.
    Schulz R, Hebert R, Boerner K (2008) Bereavement after caregiving. Geriatrics 63(1):20–22PubMedPubMedCentralGoogle Scholar
  31. 31.
    Vitaliano PP, Russo J, Scanlan JM, Greeno CG (1996) Weight changes in caregivers of Alzheimer’s care recipients: psychobehavioral predictors. Psychol Aging 11:155–63.  https://doi.org/10.1037//0882-7974.11.1.155 CrossRefPubMedGoogle Scholar
  32. 32.
    Geiker NRW, Astrup A, Hjorth MF, Sjödin A, Pijls L, Markus CR (2018) Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa? Obes Rev 19:81–97.  https://doi.org/10.1111/obr.12603 CrossRefPubMedGoogle Scholar
  33. 33.
    Brummett BH, Babyak MA, Siegler IC, Vitaliano PP, Ballard EL, Gwyther LP, Williams RB (2006) Associations among perceptions of social support, negative affect, and quality of sleep in caregivers and noncaregivers. Health Psychol 25(2):220–225.  https://doi.org/10.1037/0278-6133.25.2.220 CrossRefPubMedGoogle Scholar
  34. 34.
    Sundararajan K, Campbell MK, Choi YH, Sarma S (2014) The relationship between diet quality and adult obesity: evidence from Canada. J Am Coll Nutr 33(1):1–17.  https://doi.org/10.1080/07315724.2013.848157 CrossRefPubMedGoogle Scholar
  35. 35.
    Vgontzas AN, Bixler EO, Chrousos GP (2006) Obesity-related sleepiness and fatigue: the role of the stress system and cytokines. Ann N Y Acad Sci 1083:329–344.  https://doi.org/10.1196/annals.1367.023 CrossRefPubMedGoogle Scholar
  36. 36.
    Curcio GG, Tempesta D, Scarlata S, Marzano C, Moroni F, Rossini PM, Ferrara M, De Gennaro L (2013) Validity of the Italian version of the Pittsburgh sleep quality index (PSQI). Neurol Sci 34:511–519.  https://doi.org/10.1007/s10072-012-1085-y CrossRefPubMedGoogle Scholar
  37. 37.
    Panagiotakos DB, Pitsavos C, Stefanadis C (2006) Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Dis 16:559–568.  https://doi.org/10.1016/j.numecd.2005.08.006 CrossRefPubMedGoogle Scholar
  38. 38.
    Alberti-Fidanza A, Fidanza F (2004) Mediterranean adequacy index of Italian diets. Public Health Nutr 7:937–941.  https://doi.org/10.1079/PHN2004557 CrossRefPubMedGoogle Scholar
  39. 39.
    Alberti A, Fruttini D, Fidanza F (2009) The mediterranean adequacy index: further confirming results of validity. Nutr Metab Cardiovasc Dis 19:61–66.  https://doi.org/10.1016/j.numecd.2007.11.008 CrossRefPubMedGoogle Scholar
  40. 40.
    Radloff LS (1997) The CES-D scale: a self report depression scale for research in the general population. Appl Psychol Meas 1:385–401.  https://doi.org/10.1177/014662167700100306 CrossRefGoogle Scholar
  41. 41.
    Baglioni C, Battagliese G, Feige B, Spiegelhalder K, Nissen C, Voderholzer U, Lombardo C, Riemann D (2011) Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. J Affect Disord 135:10–19.  https://doi.org/10.1016/j.jad.2011.01.011 CrossRefPubMedGoogle Scholar
  42. 42.
    Lombardo C, Cuzzolaro M, Vetrone G, Mallia L, Violani C (2011) Concurrent validity of the Disordered Eating Questionnaire (DEQ) with the Eating Disorder Examination (EDE) clinical interview in clinical and non clinical samples. Eat Weight Disord 16(3):e188–e198CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of Social and Developmental PsychologySapienza University of RomeRomeItaly
  2. 2.Department of Family, Consumer and Human Development and Department of PsychologyUtah State UniversityLoganUSA
  3. 3.Department of PsychologySapienza University of RomeRomeItaly
  4. 4.Geriatric Unit, Faculty of Medicine and Psychology, S. Andrea HospitalSapienza University of RomeRomeItaly

Personalised recommendations