Research Article| Volume 8, ISSUE 6, P620-624, December 2022

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Daytime sleepiness, addictive-like eating, and obesity sequelae in Black and African American youth with obesity

Published:October 20, 2022DOI:



      The purpose of the current study was to examine the association between poor sleep health (ie, excessive daytime sleepiness), obesity sequelae (ie, percent overweight and serum leptin levels), and addictive-like eating behaviors, an obesity phenotype, in a sample of Black/African American (B/AA) adolescents.


      The current study analyzed archival baseline data from a sample of B/AA adolescents with obesity enrolled in a sequential randomized clinical trial.


      Data were collected in the participants’ homes by trained research assistants unaware of treatment condition.


      A sample of 181 B/AA adolescents with obesity between the ages of 12 and 16 years (M = 14.26, SD = 1.46) and having a body mass index (BMI) above the 95th percentile for age and gender were sampled.


      Self-report measures included the Cleveland Adolescent Sleepiness Questionnaire and the Yale Food Addiction Scale-Children (YFAS-C). Anthropomorphic data and blood samples were used to determine BMI and serum leptin levels, respectively.


      Excessive daytime sleepiness was positively correlated with YFAS-C symptom count, r = 0.295, P < .001. Serum leptin levels and percent overweight were both positively correlated with each other, r = 0.445, P < .001 and with YFAS-C symptom count, r = 0.215, P = .006. After controlling for age and gender, results supported an indirect effect from daytime sleepiness to both serum leptin levels (estimate = 2.210, SE = 0.932, P = .018) and percent overweight (estimate = 2.817, SE = 1.415, P = .046) through YFAS-C symptom count.


      Culturally informed interventions on eating behaviors (ie, addictive-like eating) when excessive daytime sleepiness is reported are needed. Early intervention may help prevent the onset or worsening of obesity among adolescents.


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        • Nielsen LS
        • Danielsen KV
        • Sørensen TI.
        Short sleep duration as a possible cause of obesity: critical analysis of the epidemiological evidence.
        Obes Rev. 2011; 12: 78-92
        • Eaton DK
        • McKnight-Eily LR
        • Lowry R
        • Perry GS
        • Presley-Cantrell L
        • Croft JB.
        Prevalence of insufficient, borderline, and optimal hours of sleep among high school students - United States, 2007.
        J Adolesc Health. 2010; 46: 399-401
        • Lazaratou H
        • Dikeos DG
        • Anagnostopoulos DC
        • Sbokou O
        • Soldatos CR.
        Sleep problems in adolescence. A study of senior high school students in Greece.
        Eur Child Adolesc Psychiatry. 2005; 14: 237-243
        • Wolfson AR
        • Carskadon MA.
        Sleep schedules and daytime functioning in adolescents.
        Child Dev. 1998; 69: 875-887
        • Keyes KM
        • Maslowsky J
        • Hamilton A
        • Schulenberg J.
        The great sleep recession: changes in sleep duration among US adolescents, 1991-2012.
        Pediatrics. 2015; 135: 460-468
        • Ogden CL
        • Carroll MD
        • Kit BK
        • Flegal KM.
        Prevalence of obesity among adults: United States, 2011-2012.
        NCHS Data Brief. 2013; : 1-8
        • Ogden CL
        • Flegal KM
        • Carroll MD
        • Johnson CL.
        Prevalence and trends in overweight among US children and adolescents, 1999-2000.
        JAMA. 2002; 288: 1728-1732
        • Ogden CL
        • Carroll MD
        • Kit BK
        • Flegal KM.
        Prevalence of childhood and adult obesity in the United States, 2011-2012.
        JAMA. 2014; 311: 806-814
        • Zhang H
        • Rodriguez-Monguio R.
        Racial disparities in the risk of developing obesity-related diseases: a cross-sectional study.
        Ethn Dis. 2012; 22: 308-316
        • Petersen R
        • Pan L
        • Blanck HM.
        Racial and ethnic disparities in adult obesity in the United States: CDC's tracking to inform state and local action.
        Prev Chronic Dis. 2019; 16 (Published 2019 Apr 11): E46
        • Hicks RA
        • Fernandez C
        • Pellegrini RJ.
        Striking changes in the sleep satisfaction of university students over the last two decades.
        Percept Mot Skills. 2001; 93: 660
        • Fatima Y
        • Doi SA
        • Mamun AA.
        Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis.
        Obes Rev. 2015; 16: 137-149
        • Beebe DW
        • Lewin D
        • Zeller M
        • et al.
        Sleep in overweight adolescents: shorter sleep, poorer sleep quality, sleepiness, and sleep-disordered breathing.
        Journal of Pediatric Psychology. 2007; 32: 69-79
        • Calhoun SL
        • Vgontzas AN
        • Fernandez-Mendoza J
        • et al.
        Prevalence and risk factors of excessive daytime sleepiness in a community sample of young children: the role of obesity, asthma, anxiety/depression, and sleep.
        Sleep. 2011; 34 (Published 2011 Apr 1): 503-507
        • Panossian LA
        • Veasey SC.
        Daytime sleepiness in obesity: mechanisms beyond obstructive sleep apnea–a review.
        Sleep. 2012; 35 (Published 2012 May 1): 605-615
        • Maugeri A
        • Medina-Inojosa JR
        • Kunzova S
        • et al.
        Sleep duration and excessive daytime sleepiness are associated with obesity independent of diet and physical activity.
        Nutrients. 2018; 10: 1219
        • Pelleymounter MA
        • Cullen MJ
        • Baker MB
        • et al.
        Effects of the obese gene product on body weight regulation in ob/ob mice.
        Science. 1995; 269: 540-543
        • Di Stefano G
        • Bini V
        • Papi F
        • et al.
        Leptin serum concentrations predict the responsiveness of obese children and adolescents to weight excess reduction program.
        Int J Obes Relat Metab Disord. 2000; 24: 1586-1591
        • Guzzardi MA
        • Garelli S
        • Agostini A
        • et al.
        Food addiction distinguishes an overweight phenotype that can be reversed by low calorie diet.
        Eur Eat Disord Rev. 2018; 26 (Published 2018 Oct 23): 657-670
        • Gearhardt AN
        • White MA
        • Masheb RM
        • Grilo CM.
        An examination of food addiction in a racially diverse sample of obese patients with binge eating disorder in primary care settings.
        Compr Psychiatry. 2013; 54: 500-505
        • Gearhardt AN
        • White MA
        • Potenza MN.
        Binge eating disorder and food addiction.
        Curr Drug Abuse Rev. 2011; 4: 201-207
        • Schulte EM
        • Jacques-Tiura AJ
        • Gearhardt AN
        • Naar S.
        Food addiction prevalence and concurrent validity in African American adolescents with obesity.
        Psychol Addict Behav. 2018; 32: 187-196
        • Kandeger A
        • Selvi Y
        • Tanyer DK.
        The effects of individual circadian rhythm differences on insomnia, impulsivity, and food addiction.
        Eat Weight Disord. 2019; 24: 47-55
        • Nolan LJ
        • Geliebter A.
        Validation of the Night Eating Diagnostic Questionnaire (NEDQ) and its relationship with depression, sleep quality, “food addiction”, and body mass index.
        Appetite. 2017; 111: 86-95
        • Peters T
        • Antel J
        • Föcker M
        • et al.
        The association of serum leptin levels with food addiction is moderated by weight status in adolescent psychiatric inpatients.
        Eur Eat Disord Rev. 2018; 26: 618-628
        • Naar S
        • Ellis D
        • Idalski-Carcone A
        • et al.
        Outcomes from a sequential multiple assignment randomized trial (SMART) of weight loss strategies for African American adolescents with obesity.
        Ann Behav Med. 2019; 53: 928-938
        • Spilsbury JC
        • Drotar D
        • Rosen CL
        • Redline S.
        The Cleveland adolescent sleepiness questionnaire: a new measure to assess excessive daytime sleepiness in adolescents.
        J Clin Sleep Med. 2007; 3: 603-612
        • Gearhardt AN
        • Roberto CA
        • Seamans MJ
        • Corbin WR
        • Brownell KD.
        Preliminary validation of the Yale Food Addiction Scale for children [published correction appears in Eat Behav. 2014 Apr;15(2):334].
        Eat Behav. 2013; 14: 508-512
        • Schulte EM
        • Jacques-Tiura AJ
        • Gearhardt AN
        • Naar S.
        Food addiction prevalence and concurrent validity in African American adolescents with obesity.
        Psychol Addict Behav. 2018; 32: 187-196
        • Muthén LK
        • Muthén BO
        Mplus: Statistical Analysis with Latent Variables: User's Guide.
        8th ed. Authors, Los Angeles, CA2017
        • Kline RB
        Principles and practice of structural equation modeling.
        4th ed. Guilford, New York, NY2015
        • Heptulla R
        • Smitten A
        • Teague B
        • Tamborlane WV
        • Ma YZ
        • Caprio S.
        Temporal patterns of circulating leptin levels in lean and obese adolescents: relationships to insulin, growth hormone, and free fatty acids rhythmicity.
        J Clin Endocrinol Metab. 2001; 86: 90-96
        • Duraccio KM
        • Krietsch KN
        • Chardon ML
        • Van Dyk TR
        • Beebe DW.
        Poor sleep and adolescent obesity risk: a narrative review of potential mechanisms.
        Adolesc Health Med Ther. 2019; 10 (Published 2019 Sep 9): 117-130
        • Chen X
        • Beydoun MA
        • Wang Y.
        Is sleep duration associated with childhood obesity? A systematic review and meta-analysis.
        Obesity (Silver Spring). 2008; 16: 265-274
        • Taheri S.
        The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity.
        Arch Dis Child. 2006; 91: 881-884
        • Berkowitz R
        • Stunkard AJ
        • Stallings VA.
        Binge-eating disorder in obese adolescent girls.
        Ann N Y Acad Sci. 1993; 699: 200-206
        • Li JTE
        • Pursey KM
        • Duncan MJ
        • Burrows T.
        Addictive eating and its relation to physical activity and sleep behavior.
        Nutrients. 2018; 10 (Published 2018 Oct 4): 1428
        • Schulte EM
        • Gearhardt AN.
        Associations of food addiction in a sample recruited to be nationally representative of the United States.
        Eur Eat Disord Rev. 2018; 26: 112-119
        • Magee L
        • Hale L.
        Longitudinal associations between sleep duration and subsequent weight gain: a systematic review [published correction appears in Sleep Med Rev. 2012 Oct;16(5):491].
        Sleep Med Rev. 2012; 16: 231-241
        • Kruger AK
        • Reither EN
        • Peppard PE
        • Krueger PM
        • Hale L.
        Do sleep-deprived adolescents make less-healthy food choices?.
        Br J Nutr. 2014; 111: 1898-1904
        • Holm SM
        • Forbes EE
        • Ryan ND
        • Phillips ML
        • Tarr JA
        • Dahl RE.
        Reward-related brain function and sleep in pre/early pubertal and mid/late pubertal adolescents.
        J Adolesc Health. 2009; 45: 326-334
        • Weiss A
        • Xu F
        • Storfer-Isser A
        • Thomas A
        • Ievers-Landis CE
        • Redline S.
        The association of sleep duration with adolescents' fat and carbohydrate consumption.
        Sleep. 2010; 33: 1201-1209
        • Demos KE
        • Sweet LH
        • Hart CN
        • et al.
        The Effects of Experimental Manipulation of Sleep Duration on Neural Response to Food Cues.
        Sleep. 2017; 40: zsx125
        • Magee L
        • Hale L.
        Longitudinal associations between sleep duration and subsequent weight gain: a systematic review [published correction appears in Sleep Med Rev. 2012 Oct;16(5):491].
        Sleep Med Rev. 2012; 16: 231-241
        • Lustig RH.
        Childhood obesity: behavioral aberration or biochemical drive? Reinterpreting the First Law of Thermodynamics.
        Nat Clin Pract Endocrinol Metab. 2006; 2: 447-458
        • Myers Jr, MG
        • Heymsfield SB
        • Haft C
        • et al.
        Challenges and opportunities of defining clinical leptin resistance.
        Cell Metab. 2012; 15: 150-156
        • Kral TVE
        • Moore RH
        • Chittams J
        • Jones E
        • O'Malley L
        • Fisher JO.
        Identifying behavioral phenotypes for childhood obesity.
        Appetite. 2018; 127: 87-96
        • Dalleck LC
        • Van Guilder GP
        • Richardson TB
        • Bredle DL
        • Janot JM.
        A community-based exercise intervention transitions metabolically abnormal obese adults to a metabolically healthy obese phenotype.
        Diabetes Metab Syndr Obes. 2014; 7 (Published 2014 Aug 1): 369-380
        • Boutelle KN
        • Kang Sim DE
        • Manzano M
        • et al.
        Role of appetitive phenotype trajectory groups on child body weight during a family-based treatment for children with overweight or obesity.
        Int J Obes. 2019; 43: 2302-2308