Peer-reviewedCC BY 4.0Journal of Obesity2 Nov 2026

Nonlinear Relationship of Weight‐Adjusted Waist Index With Self‐Reported Trouble Sleeping and the Mediating Role of Depression

Yuhan Song¹
Zhaoxiang Wang¹
Xuejing Shao²
Shao Zhong¹

¹Department of Endocrinology Affiliated Kunshan Hospital of Jiangsu University Kunshan Jiangsu 215300 China ujs.edu.cn
²Department of Endocrinology Affiliated Wujin Hospital of Jiangsu University Wujin Clinical College of Xuzhou Medical University Changzhou Jiangsu 213017 China

Abstract

Purpose: The weight‐adjusted waist index (WWI) is a novel measure for obesity that appears to outperform body mass index (BMI) and waist circumference (WC) in assessing lean and fat mass. Our aim was to explore the possible link between WWI and trouble sleeping.

Methods: This cross‐sectional study included 30,999 adults who participated in the National Health and Nutrition Examination Survey (NHANES) database. The WWI was calculated as WC (cm) divided by the square root of weight (kg). Trouble sleeping is based on a self‐reported medical history. The relationship between WWI and trouble sleeping was explored through logistic regression, smooth curve fitting, mediation analysis, and receiver operating characteristic (ROC) analysis.

Results: As WWI levels increase, self‐reported trouble sleeping becomes more prevalent (20.96% vs. 25.97% vs. 30.26% vs. 37.15%, p < 0.001). Multivariable logistic regression analysis showed that higher WWI was associated with a greater likelihood of self‐reported trouble sleeping (OR [95%CI]: 1.10 [1.03–1.18], p = 0.005). ROC analysis showed modest discrimination for WWI, with an area under the curve (AUC) of 0.6041. Smooth curve fitting uncovered a nonlinear relationship, with a breakpoint at 11.04. Additionally, depression partly mediated the WWI‐trouble sleeping connection.

Conclusions: Higher WWI was associated with a higher prevalence of self‐reported trouble sleeping. Although WWI may serve as a practical anthropometric indicator, its modest discriminatory ability and the cross‐sectional study design warrant cautious interpretation.

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Cite

BibTeX RIS

BibTeX

@article{song2026nonlinear,
  title = {{Nonlinear Relationship of Weight‐Adjusted Waist Index With Self‐Reported Trouble Sleeping and the Mediating Role of Depression}},
  author = {Yuhan Song and Zhaoxiang Wang and Xuejing Shao and Shao Zhong},
  journal = {Journal of Obesity},
  year = {2026},
  month = nov,
  doi = {10.1155/jobe/8895676},
  url = {https://doi.org/10.1155/jobe/8895676},
  note = {CC BY 4.0},
}

RIS

TY  - JOUR
TI  - Nonlinear Relationship of Weight‐Adjusted Waist Index With Self‐Reported Trouble Sleeping and the Mediating Role of Depression
AU  - Yuhan Song
AU  - Zhaoxiang Wang
AU  - Xuejing Shao
AU  - Shao Zhong
PY  - 2026
DA  - 2026/11/02
JO  - Journal of Obesity
DO  - 10.1155/jobe/8895676
UR  - https://doi.org/10.1155/jobe/8895676
AB  - Purpose: The weight‐adjusted waist index (WWI) is a novel measure for obesity that appears to outperform body mass index (BMI) and waist circumference (WC) in assessing lean and fat mass. Our aim was to explore the possible link between WWI and trouble sleeping.  Methods: This cross‐sectional study included 30,999 adults who participated in the National Health and Nutrition Examination Survey (NHANES) database. The WWI was calculated as WC (cm) divided by the square root of weight (kg). Trouble sleeping is based on a self‐reported medical history. The relationship between WWI and trouble sleeping was explored through logistic regression, smooth curve fitting, mediation analysis, and receiver operating characteristic (ROC) analysis.  Results: As WWI levels increase, self‐reported trouble sleeping becomes more prevalent (20.96% vs. 25.97% vs. 30.26% vs. 37.15%, p < 0.001). Multivariable logistic regression analysis showed that higher WWI was associated with a greater likelihood of self‐reported trouble sleeping (OR [95%CI]: 1.10 [1.03–1.18], p = 0.005). ROC analysis showed modest discrimination for WWI, with an area under the curve (AUC) of 0.6041. Smooth curve fitting uncovered a nonlinear relationship, with a breakpoint at 11.04. Additionally, depression partly mediated the WWI‐trouble sleeping connection.  Conclusions: Higher WWI was associated with a higher prevalence of self‐reported trouble sleeping. Although WWI may serve as a practical anthropometric indicator, its modest discriminatory ability and the cross‐sectional study design warrant cautious interpretation.
SN  - 2090-0708
SN  - 2090-0716
ER  -

Abstract

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