Association between A Body Shape Index (ABSI) and sleep quality: a cross-sectional study from 2022–2025

Sleep disturbances are linked to a wide array of adverse outcomes, including increased risks of illness, depression, and mortality. This study aimed to investigate the relationship between sleep quality and A Body Shape Index (ABSI) in adults. A total of 4,091 participants aged 18–65 years were recruited between 2022 and 2025. ABSI was calculated using standard equations incorporating height, weight, and waist circumference. The Pittsburgh Sleep Quality Index (PSQI) and wearable actigraphy devices were used to assess subjective and objective sleep quality, respectively. Outcome measures included sleep duration, sleep disturbances, sleep latency, and daytime dysfunction due to sleepiness. Results showed Higher ABSI was significantly associated with poorer sleep quality across multiple domains. Prevalence of inadequate sleep quality increased from 21.8% in ABSI Tertile 1 (T1) to 44.8% in Tertile 3 (T3) ( p < 0.001). Participants in T3 had significantly higher odds of inadequate sleep quality (OR: 1.20; 95% CI: 1.02–1.41). Higher ABSI was also associated with shorter sleep duration, greater sleep disturbances (OR: 1.60), longer sleep latency (OR: 1.35), increased daytime dysfunction (OR: 1.65), lower sleep efficiency (OR: 1.55), poorer self-rated sleep quality (OR: 1.65). Inadequate sleep quality was associated with increased ABSI, which could be valuable in detecting visceral and sarcopenic obesity in adults, enhancing existing anthropometric measurements with useful clinical data.