Norton Maria C, Eleuteri Stefano, Cerolini Silvia, Ballesio Andrea, Conte Salvatore C, Falaschi Paolo, Lucidi Fabio
Department of Family, Consumer and Human Development and Department of Psychology, Utah State University, Logan, UT, USA.
Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy.
Eat Weight Disord. 2018 Feb;23(1):23-38. doi: 10.1007/s40519-017-0453-2. Epub 2017 Oct 28.
To address the worldwide epidemic of obesity, a sizable literature implicates sleep problems in the onset of obesity in younger populations. However, less is known about how this process may operate among older adults, which is of concern, given demographic shifts that have resulted in a much higher proportion of developed nations around the world reaching late life.
We offer a current review of the literature studying older adults and examining associations between sleep quality and obesity in this population. We consider both subjective and objectively measured sleep as well as both cross-sectional and longitudinal studies offering stronger causal inference.
We discuss seemingly contradictory literature showing that shorter sleep duration as well as longer sleep duration are associated with obesity risk, then review studies that tested for non-linear relationships and reported a U-shape pattern, suggesting that too much or too little sleep is detrimental. Besides sleep duration, we discuss evidence showing that other forms of sleep dysfunction related to night-time awakenings, REM sleep, slow-wave sleep, and daytime sleepiness, which are indicators of sleep quality, are also linked to obesity. Specific psychological and physiological mediators and moderators, suggesting possible mechanisms whereby sleep problems may affect obesity in older adults, are described.
We conclude by discussing areas, where additional research could help clarify this association, considering such factors as medical comorbidities common in late life, and health-related behaviors that may stem from poor sleep (such as disordered eating behavior). Such insights will have great value for clinical practice.
Level V, narrative review.
为应对全球肥胖流行问题，大量文献表明睡眠问题与年轻人群肥胖的发生有关。然而，对于这一过程在老年人中如何起作用，我们知之甚少。鉴于人口结构变化导致世界上发达国家中达到老年的人口比例大幅增加，这一问题值得关注。
我们对研究老年人以及探讨该人群睡眠质量与肥胖之间关联的文献进行了综述。我们考虑了主观和客观测量的睡眠情况，以及提供更强因果推断的横断面研究和纵向研究。
我们讨论了看似相互矛盾的文献，这些文献表明较短的睡眠时间以及较长的睡眠时间都与肥胖风险相关，然后回顾了测试非线性关系并报告呈U形模式的研究，这表明睡眠过多或过少都有害。除了睡眠时间，我们还讨论了证据表明，与夜间觉醒、快速眼动睡眠、慢波睡眠和白天嗜睡相关的其他形式的睡眠功能障碍，这些都是睡眠质量的指标，也与肥胖有关。文中描述了特定的心理和生理调节因素，提示了睡眠问题可能影响老年人肥胖的潜在机制。
我们通过讨论一些领域来得出结论，在这些领域中，进一步的研究有助于阐明这种关联，同时考虑到老年期常见的医学合并症以及可能源于睡眠不佳的健康相关行为（如饮食行为紊乱）等因素。这些见解对临床实践具有重要价值。
V级，叙述性综述。
