Sleep duration and overweight in European children: Is the association modified by geographic region?

Sabrina Hense, Hermann Pohlabeln, Stefaan De Henauw, Gabriele Eiben, Dénes Molnar, Luis A. Moreno, Gianvincenzo Barba, Charalampos Hadjigeorgiou, Toomas Veidebaum, Wolfgang Ahrens

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Study Objectives: To investigate differences and a possible effect modification by geographical region in the association between sleep duration and overweight. Design: Cross-sectional. Setting: Primary schools and preschools in 8 European countries. Participants: 7867 children aged 2 to 9 years. Interventions: Not applicable. Measurements: Nocturnal sleep duration was assessed as part of a parental 24-h recall. Height and weight were measured by standardized procedures across centers. Data on personal, social, environmental and behavioral factors were collected using a standardized parental questionnaire. Results: Sleep duration differed (P < 0.001) between European regions and normal vs. overweight children. A dose-dependent inverse association between sleep duration and overweight could be seen, with crude odds ratios ranging from 1.73 (99% CI 1.33; 2.25) for sleeping between 10 and 11 h to 3.81 (99% CI 2.85; 5.09) for sleeping less than 9 h (reference category > 11 h). This persisted after adjustment, but remained significant only for sleeping less than 9 h per night (north: OR = 1.70; 99% CI 1.13; 2.58 vs. south: OR = 2.84; 99% CI 1.57; 5.12) if stratified by region. No effect modification by region could be found, but adjustment for region accounted for changes in the effect estimate for sleeping less than 9 h (OR = 2.22; 99% CI 1.64; 3.02). The association was stronger in school children than in preschool children. Conclusion: Geographic region and related aspects - even if they do not seem to modify the association between sleep and overweight - should in any case be taken in consideration as a confounding factor on this association.

Original languageEnglish
Pages (from-to)885-890
Number of pages6
Issue number7
Publication statusPublished - Jul 1 2011



  • Cross-sectional
  • Epidemiological study
  • Preschool children
  • School children

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)

Cite this

Hense, S., Pohlabeln, H., De Henauw, S., Eiben, G., Molnar, D., Moreno, L. A., Barba, G., Hadjigeorgiou, C., Veidebaum, T., & Ahrens, W. (2011). Sleep duration and overweight in European children: Is the association modified by geographic region? Sleep, 34(7), 885-890.