All ETDs from UAB

Advisory Committee Chair

Marti Rice

Advisory Committee Members

Olivia Affuso

Pamela Bowen

Paula Chandler-Laney

Peng Li

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Nursing


Introduction: Abdominal adiposity and blood pressure (BP) are two major modifiable risk factors for cardiovascular disease (CVD), the leading cause of death in the world. The impact of abdominal adiposity and BP on health, particularly CVD, begins in childhood. Older adolescents tend to have the highest prevalence of abdominal adiposity and BP in the pediatric population. Despite interventions like diet and exercise, the prevalence of excess abdominal adiposity and elevated BP continues to increase during late adolescence. Evidence suggests that sleep duration and sleep efficiency impact abdominal adiposity and BP in adults and the pediatric population, but limited studies have focused on these relationships during late adolescence. Therefore, the purpose of this study is to determine if sleep duration and sleep efficiency influence abdominal adiposity and BP during late adolescence. Methods: A secondary data analysis was conducted on data extracted from the third cohort of the Cleveland Children’s Sleep and Health Study (CCSHS). Actigraphy data (objective sleep duration, sleep efficiency), subjective sleep duration data from sleep diaries, waist circumference (WC) percentiles, WC and height (used to calculate waist-to- iv height ratio [WHtR]), BP, BMI percentiles, age, race, ethnicity, and assigned sex were extracted for analysis. Results: Two hundred and ninety-seven adolescents ages 16.1 – 18.9 (mean 17.7±0.4) were included in this study. The majority of the participants were female (55.6%), White (63.3%), non-Hispanic (96.0%), and normal weight (67.7%). The participants on average had inadequate objective sleep duration, adequate subjective sleep duration, normotensive systolic and diastolic BP, and did not have excess abdominal adiposity. Sleep efficiency had a negative relationship with WHtR and SBP. However, these relationships did not persist after controlling for BMI percentiles, race, and assigned sex. Conclusions: In this sample, there were no relationships between sleep duration and sleep efficiency and abdominal adiposity and BP. Future research should examine the differences between objective and subjective sleep duration in late adolescents and differences based on BMI percentiles, race, and assigned sex. There is also a need for research exploring whether other sleep health variables beyond duration and efficiency (e.g., satisfaction, sleepiness, timing, behaviors) have a relationship with abdominal adiposity or blood pressure.

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Nursing Commons