Poor sleep quality is associated with obesity. A possible mechanism is the impact sleep quality has on eating behaviors.In adults, poor sleep quality is associated with eating in response to external cues; however, less is known about the relationship in youth. The objective of the study was to assess the strength of association between sleep quality and eating behaviors, accountingfor adiposity, in pediatric participants.


Caregiver-reported measures of pediatric sleep quality (measured by the Pediatric Quality of Life (PedsQL) Fatigue Scale) and eating behaviors (measured by the Child Eating Behavior Questionnaire (CEBQ)) were obtained on participants (8-17 years).Percent body fat (%BF) was measured by iDXA. Generalized linear regression was performed to evaluate the associations between sleep QL and eating behaviors adjusting for age, sex, race, ethnicity, and %BF.


Of the 353 participants (49% female), 39% had normal weight, 6% overweight, 21% Class I Obesity, 20% Class II Obesity, and 14% Class III Obesity. Poorer sleep QL was associated with higher food responsiveness (β -0.017; p<0.001), higher emotional overeating (β -0.023; p<0.001), higher enjoyment of food (β -0.005; p=0.037), and higher desire to drink (β -0.012; p<0.001). When adjusting for %BF, emotional overeating (β -0.02; p=0.016) and desire to drink (β -0.032; p=0.001) remained associated with poorer sleep QL.


Poor sleep QL was associated with food approach behaviors (food responsiveness, emotional overeating, enjoyment of food, and desire to drink) in youths across BMI classifications. Only emotional overeating and desire to drink were associated with poorer sleep QL after accountingfor %BF.This suggests that adiposity influences the relationship of sleep QL with food responsiveness and enjoyment of food. The relationship between sleep QL and eating behaviors in youth warrants further investigation, particularly as it relates to weight management practices.