Sleep quality, emotional and behavioral disturbances, and eating behavior in adolescents with obesity: a structural equation modeling

• Published in: Somnologie : Schlafforschung und Schlafmedizin = Somnology : sleep research and sleep medicine 2023-06, Vol.27 (2), p.90-101
• Main Author: Kelmanson, Igor A.
• Format: Article
• Language: English
• Subjects: Calories; Cardiology; Eating behavior; Internal Medicine; Medicine; Medicine & Public Health; Neurology; Obesity; Original Studies; Otorhinolaryngology; Pneumology/Respiratory System; Psychology; Teenagers
• ISSN: 1432-9123; 1439-054X
• DOI: 10.1007/s11818-023-00405-8

Background Sleep disorders and emotional and behavioral disturbances, including unhealthy eating behaviors, are common findings in obesity. This study aimed to examine possible associations between the above factors in adolescents with obesity using structural equation modeling. Methods A total of 94 adolescents (30 girls, 64 boys) aged 11–17 (mean 14.9 ± 1.7) years with obesity (ICD-10 code E 66.0) entered the study. The Adolescent Sleep Wake Scale (ASWS) was used to evaluate sleep quality. The Achenbach Youth Self-Report for Ages 11–18 (YSR) questionnaire was used to evaluate emotional and behavioral disturbances. The Dutch Eating Behavior Questionnaire (DEBQ) was used for assessment of eating behavior. Structural equation modeling (SEM) was used to establish a predictive relationship between the variables under consideration. Results The model in which sleep quality was a predictor of emotional distress and disinhibited behavior (latent variables), and in which the latter, in turn, were predictors of the eating behavior subscales, fit the sample data very well. Poor sleep quality was a significant predictor of emotional distress and of disinhibited behavior. Emotional distress was a significant predictor of emotional and restrictive eating, and disinhibited behavior was a significant predictor of external eating. Conclusion Poor sleep quality may promote unhealthy eating habits in adolescents with obesity, most likely due to mediating effects of emotional distress and disinhibited behavior.