Short sleep has been associated with adolescent obesity. Most studies used a cross-sectional design and modeled BMI categories. We sought to determine if sleep duration was associated with BMI distribution changes from age 14 to 18.


Adolescents were recruited from suburban high schools in Philadelphia when entering ninth grade (n = 1390) and were followed-up every 6 months through 12th grade. Height and weight were self-reported, and BMIs were calculated (kg/m2). Hours of sleep were self-reported. Quantile regression was used to model the 10th, 25th, 50th, 75th, and 90th BMI percentiles as dependent variables; study wave and sleep were the main predictors.


BMI increased from age 14 to 18, with the largest increase observed at the 90th BMI percentile. Each additional hour of sleep was associated with decreases in BMI at the 10th (–0.04; 95% confidence interval [CI]: –0.11, 0.03), 25th (–0.12; 95% CI: –0.20, –0.04), 50th (–0.15; 95% CI: –0.24, –0.06), 75th (–0.25; 95% CI: –0.38, –0.12), and 90th (–0.27; 95% CI: -0.45, -0.09) BMI percentiles. The strength of the association was stronger at the upper tail of the BMI distribution. Increasing sleep from 7.5 to 10.0 hours per day at age 18 predicted a reduction in the proportion of adolescents >25 kg/m2 by 4%.


More sleep was associated with nonuniform changes in BMI distribution from age 14 to 18. Increasing sleep among adolescents, especially those in the upper half of the BMI distribution, may help prevent overweight and obesity.

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