Gender, Sleep Problems, and Obesity in Taiwan: A Propensity-Score-Matching Approach

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Abstract
Obesity has become a major health risk in industrialized countries, with disturbed sleep identified as a correlate. This study used data drawn from Taiwan's 2005 Social Development Trend Survey on Health and Safety and the propensity-score-matching method to shed light on gender-specific associations between sleep problems and obesity among 24,113 adults aged 20-64 years. The average increase in obesity prevalence among respondents with disrupted sleep was 1.85%, as compared to those who did not report disrupted sleep, with similar psycho-social attributes. Similarly, the prevalence of obesity among those who reported restless sleep was increased by an average of 1.40% compared to those who did not report restless sleep with similar psycho-social attributes. We also found gender-specific vulnerability to different types of sleep problems. Among men who reported disrupted sleep, we found a 3.12% increase in the prevalence of obesity. Among women exposed to restless sleep, the increase in obesity prevalence was 1.84%. The observed gender difference in the prevalence of increases in obesity may be attributed to gender-specific behavioral responses to poor sleep. With poor sleep, men may respond to hunger by overeating; women may respond by physical inactivity. Both can contribute to an elevated risk of obesity.

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