Chronic Sleep Curtailment and Adiposity

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Curtailed sleep in children has been found to be associated with increased cardiovascular disease risk factors, including obesity. Few existing studies have examined measures of adiposity beyond BMI or have examined the effects of being chronically sleep curtailed. WHAT THIS STUDY ADDS:In this cohort of children who had research-level measures of sleep, BMI, total fat mass, and fat mass distribution, we found that chronic sleep curtailment from infancy to age 7 years was associated with higher overall and central adiposity in mid-childhood. abstract OBJECTIVES: To examine the extent to which chronic sleep curtailment from infancy to mid-childhood is associated with total and central adiposity. METHODS:We studied 1046 children participating in a prospective cohort study. At age 6 months and yearly from age 1 to 7 years, mothers reported their children' s sleep duration in a usual 24-hour period. The main exposure was a sleep curtailment score from age 6 months to 7 years. The range of the total score was 0 to 13, where 0 indicated the maximal sleep curtailment and 13 indicated never having curtailed sleep. Outcomes in mid-childhood were BMI z score, dual X-ray absorptiometry total and trunk fat mass index (kg/m 2 ), and waist and hip circumferences (cm). RESULTS:The mean (SD) sleep score was 10.2 (2.7); 4.4% scored a 0 to 4, indicating multiple exposures to sleep curtailment between age 6 months to 7 years, 12.3% scored 5 to 7, 14.1% scored 8 to 9, 28.8% scored 10 to 11, and 40.3% scored 12 to 13. In multivariable models, children who had a sleep score of 0 to 4 had a BMI z score that was 0.48 U (95% confidence interval, 0.13 to 0.83) higher than those who had a sleep score of 12 to 13. We observed similar associations of higher total and trunk fat mass index and waist and hip circumferences, and higher odds of obesity (odds ratio, 2.62; 95% confidence interval, 0.99 to 6.97) among children who had a score of 0 to 4 vs 12 to 13. CONCLUSIONS:Chronic sleep curtailment from infancy to school age was associated with higher overall and central adiposity in midchildhood. Dr Taveras conceptualized and designed the study, obtained funding, and drafted the initial manuscript; Dr Gillman assisted with the conceptualization and design of the study, helped obtain funding, and reviewed and revised the manuscript; Dr Redline assisted with the conceptualization and design of the study, helped obtain funding, and reviewed and revised the manuscript; Ms Peña assisted with the conceptualization of the study exposure definitions and reviewed and revised the manuscript; Ms Shiman carried out the initial analyses and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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