A twin study of sleep duration and body mass index

Watson NF, Buchwald D, Vitiello M, Noonan C, Goldberg J

To determine the relative importance of genetic and environmental contributions to the association between sleep duration and body mass index (BMI), twins from the University of Washington Twin Registry, a community-based sample of U.S. twins, provided self-reported height and weight for BMI calculation and habitual sleep duration. A generalized estimating equation model evaluated the overall and within twin pair effects of sleep duration on BMI with and without stratification by twin zygosity. A structural equation model was used to assess genetic and non-genetic contributions to BMI and sleep duration. The study sample included 1,224 twins comprised of 423 monozygotic, 143 dizygotic, and 46 indeterminate pairs. The mean age was 36.9 years; 69% were female. A multivariate adjusted analysis of all twins revealed an elevated mean BMI (26.0 kg/m2) in short sleeping twins (< 7 h/night) compared to twins sleeping 7–8.9 h/night (BMI 24.8 kg/m2; p < 0.01). The within-twin pair analysis revealed similar results, with the short sleeping twins having a mean BMI of 25.8 kg/m2 compared to 24.9 kg/m2 for the 7–8.9 h/night sleep duration group (p = 0.02). When restricted to monozygotic twins, the within-twin pair analysis continued to reveal an elevated BMI in the short sleeping twins (25.7 kg/m2) compared to the 7–8.9 h/night reference group (24.7 kg/m2; p = 0.02). No differences in mean BMI were observed between the 7–8.9 h/night reference group twins and longer sleeping twins (≥ 9 h/night) in the analysis of all twins, the overall within-twin pair analysis, or the within-twin pair analysis stratified by zygosity. The heritability of sleep duration was 0.31 (p = 0.08) and BMI 0.76 (p < 0.01). Bivariate genetic analysis revealed little evidence of shared genetics between sleep duration and BMI (p = 0.28). Short sleep was associated with elevated BMI following careful adjustment for genetics and shared environment. These findings point toward an environmental cause of the relationship between sleep duration and BMI.


A twin study of sleep duration and body mass index. J Clin Sleep Med. 2010; 6(1):11-17.