Bidirectional Links between Sleep Disorders and Obesity

Dr. Jayashree Swain, IMS and SUM Hospital, Bhubaneswar, Odisha, India

“Obesity and sleep disorders form a harmful cycle affecting cardiometabolic and mental health, where obesity increases sleep disorders and poor sleep promotes weight gain, highlighting the need for integrated assessment and management strategies.”

Obesity and sleep disorders are very common and strongly influence each other, and together pose a major public health challenge. Growing evidence shows a bidirectional relationship in which poor sleep promotes weight gain, while obesity increases the risk of sleep disorders. Inadequate sleep and poor sleep quality disturb appetite-regulating hormones such as leptin and ghrelin, leading to increased hunger, higher calorie intake, reduced physical activity, and metabolic imbalance. Over time, these changes contribute to obesity and related cardiometabolic diseases.

It has been observed that individuals with obesity are more likely to develop sleep disorders, particularly obstructive sleep apnea (OSA), insomnia, and restless leg syndrome. These conditions worsen sleep fragmentation, activate inflammatory and sympathetic pathways, and further impair glucose and lipid metabolism. Short sleep duration, defined as six hours or less in adults, affects a large proportion of the population and has been consistently associated with higher body mass index, insulin resistance, hypertension, and type 2 diabetes. Habitual short sleep further increases cardiometabolic risk, especially when combined with insomnia.

Mental health also plays an important role in this interaction. Obesity, sleep disturbances, depression, and anxiety share common inflammatory and neuroendocrine pathways, creating a cycle of worsening physical and psychological health.

Overall, the close and bidirectional link between obesity and sleep disorders highlights the need to routinely assess sleep in individuals with obesity and to adopt integrated treatment strategies that address sleep, metabolic health, and mental well-being together.

(Source: Figorilli M, Velluzzi F, Redolfi S. Obesity and sleep disorders: a bidirectional relationship. Nutr Metab Cardiovasc Dis. 2025;35(6):104014. doi:10.1016/j.numecd.2025.104014.; https://pubmed.ncbi.nlm.nih.gov/40180826/)