Study Identifies a Decrease in Sleep Quality and Increase in Obesity Post-Pandemic

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The changes in sleep quality were notably associated with a higher prevalence of obesity indicators in men following the COVID-19 outbreak.

Findings from a follow up study evaluating the effects of obesity and changes in sleep status demonstrated the detrimental effect the COVID-19 pandemic had on sleep health. Investigators observed a reduced sleep duration and an increase in poor sleep among middle-aged Koreans.1

The changes in sleep quality were notably associated with a higher prevalence of obesity indicators in men.

The COVID-19 pandemic caused disruption in lifestyles resulting in higher stress levels and altered sleep patterns. A team of investigators from the Korea Institute of Oriental Medicine aimed to examine the changes in sleep status before and after COVID-19 with a specific focus on sex differences, in order to explore the association between sleep status and obesity indicators.

The study, featured at SLEEP 2023 in Indianapolis, IN, gathered data from the Korean Medicine Daejeon Citizen Cohort, a prospective cohort study consisting of individuals aged 30 - 59. A baseline survey was conducted from 2017 - 2019, prior to the COVID-19 outbreak, and a follow-up survey took place from 2020 - 2021, during the pandemic.

A total of 1436 participants, including 422 men and 1014 women, completed the follow-up survey. Sleep status was assessed using the Pittsburgh Sleep Quality Index (PSQI), which evaluated sleep duration, sleep quality, and provided a composite sleep quality score.

Significant changes in sleep duration and sleep quality scores were identified before and after COVID-19. Sleep duration decreased by 13.88 minutes for men and 11.23 minutes for women, yielding average sleep durations of 6.54 hours (SD, 1.2) for men and 6.48 hours (SD, 1.2) for women.

In the analysis, participants were categorized into 2 groups, good sleep or poor sleep, based on their PSQI scores (PSQI score ≥ 5). Obesity indicators, including body mass index (BMI), waist circumference (WC), body fat mass (BFM), and percent body fat (PBF), were measured.

Sleep quality scores increased by 1.03 points among men and 0.7 among women, resulting in revealing mean scores of 5.2 points for and 5.7 points, respectively.

The proportion of individuals reporting poor sleep significantly escalated after COVID-19 compared with before the onset of the pandemic. For men, the prevalence of poor sleep increased from 25.6% - 38.6%, and for women the increase went from 36.5% to 43.1%.

Changes in sleep status and obesity indicators were analyzed using statistical tests, such as Fisher's exact test, paired t-test, and ANCOVA, with adjustments for age. The data were stratified by sex to assess sex-specific effects.

Significant differences in obesity indexes were observed only in men. Men with poor sleep quality (PSQI group) exhibited significant increases in waist circumference (Δ3.4 cm), body fat mass (Δ1.3 kg), and percent body fat (Δ1.2%) compared with men with good sleep quality.

This follow up study highlighted the importance of addressing sleep disturbances and promoting healthy habits during times of crisis, such as the COVID-19 pandemic, to mitigate the potential negative health consequences, investigators noted.


  1. Baek Y, Jung K, Kim J, Lee S. 0965 Changes in sleep status and the effects of obesity indexed by sex before and after COVID-19: a 2-year follow-up cohort study. SLEEP. 2023;46(Supplement_1):A425-A426.