Does Sleep Duration Predict Metabolic Risk in Obese Adolescents Attending Tertiary Services? A Cross-Sectional Study

Sung, Valerie; Beebe, Dean W.; VanDyke, Rhonda; Fenchel, Matthew; Crimmins, Nancy A.; Kirk, Shelley; Hiscock, Harriet; Amin, Raouf S.; Wake, Melissa

doi:10.5665/sleep.1122

Cited by 46 publications

(33 citation statements)

References 56 publications

(60 reference statements)

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“…35 The other found that short sleep was related to high fasting glucose in obese but not nonobese children. 33 Five studies reported no associations; 24;26;36–38 all of these were studies of the metabolic syndrome and 1 was from a sample in a weight management clinic. In sum, the majority of the evidence suggests that sleep characteristics are related to indices of glucose and insulin metabolism.…”

Section: Resultsmentioning

confidence: 99%

Sleep characteristics and cardiovascular risk in children and adolescents: an enumerative review

2016

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Cardiovascular risk factors develop in childhood and adolescence. This enumerative review addresses whether sleep characteristics, including sleep duration, continuity, quality, and daytime sleepiness, are associated with cardiovascular risk factors in young people. Thirty-nine studies were identified that examined the following risk factors: metabolic syndrome, glucose and insulin, lipids, blood pressure, and cardiovascular responses to psychological stressors. Due to the availability of other reviews, 16 longitudinal studies of obesity published in 2011 and later were also included in this report. Excluded from the review were studies of participants with suspected or diagnosed sleep disorders and reports from sleep deprivation experiments. Combining studies, evidence was strongest for obesity, followed by glucose, insulin, blood pressure (especially ambulatory blood pressure) and parasympathetic responses to psychological stressors. There was little evidence for metabolic syndrome cluster, lipids, and blood pressure responses to psychological stressors. The more positive associations were obtained for studies that incorporated objective measures of sleep and included adolescents. The foundational evidence is almost entirely cross-sectional, except for work on obesity. In summary, available evidence suggests that the associations between sleep characteristics and cardiovascular risk vary by risk factor. It is time to conduct studies to determine antecedent and consequent relationships and to expand risk factors to include markers of inflammation.

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Section: Resultsmentioning

confidence: 99%

Sleep characteristics and cardiovascular risk in children and adolescents: an enumerative review

2016

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“…However, none of these sleep measures were associated with the MetS-score in our cross-sectional analysis. Another study using accelerometers in obese adolescents found no association between sleep duration and the prevalence of metabolic syndrome [38]. Other studies using accelerometer-determined sleep duration and quality found a negative association with blood pressure [39] or no association [40], whereas evidence for a link between short sleep duration and insulin resistance [41]–[45] or waist circumference [46] is more evident.…”

Section: Discussionmentioning

confidence: 97%

Low Physical Activity Level and Short Sleep Duration Are Associated with an Increased Cardio-Metabolic Risk Profile: A Longitudinal Study in 8-11 Year Old Danish Children

et al. 2014

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BackgroundAs cardio-metabolic risk tracks from childhood to adulthood, a better understanding of the relationship between movement behaviors (physical activity, sedentary behavior and sleep) and cardio-metabolic risk in childhood may aid in preventing metabolic syndrome (MetS) in adulthood.ObjectiveTo examine independent and combined cross-sectional and longitudinal associations between movement behaviors and the MetS score in 8-11 year old Danish children.DesignPhysical activity, sedentary time and sleep duration (seven days and eight nights) were assessed by accelerometer and fat mass index (fat mass/height2) was assessed using Dual-energy X-ray absorptiometry. The MetS-score was based on z-scores of waist circumference, mean arterial blood pressure, homeostatic model assessment of insulin resistance, triglycerides and high density lipoprotein cholesterol. All measurements were taken at three time points separated by 100 days. Average of the three measurements was used as habitual behavior in the cross-sectional analysis and changes from first to third measurement was used in the longitudinal analysis.Results723 children were included. In the cross-sectional analysis, physical activity was negatively associated with the MetS-score (P<0.03). In the longitudinal analysis, low physical activity and high sedentary time were associated with an increased MetS-score (all P<0.005); however, after mutual adjustments for movement behaviors, physical activity and sleep duration, but not sedentary time, were associated with the MetS-score (all P<0.03). Further adjusting for fat mass index while removing waist circumference from the MetS-score rendered the associations no longer statistically significant (all P>0.17). Children in the most favorable tertiles of changes in moderate-to-vigorous physical activity, sleep duration and sedentary time during the 200-day follow-up period had an improved MetS-score relative to children in the opposite tertiles (P = 0.005).ConclusionThe present findings indicate that physical activity, sedentary time and sleep duration should all be targeted to improve cardio-metabolic risk markers in childhood; this is possibly mediated by adiposity.

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“…In a cross-sectional study of 133 obese adolescents, neither objective (actigraph, Mini-Motionlogger; Ambulatory Monitoring, Inc, Ardsley, New York) nor subjective (parent and self-report) sleep duration were associated with individual metabolic outcomes nor did any measures of sleep duration differ in the presence versus absence of metabolic syndrome. 59 The authors noted the unexpected finding that short sleep duration was associated with lower triglyceride and increased HDL-C levels. Our use of a continuous cMetScore rather than evaluation of its individual components may, in part, explain the differences in findings.…”

Section: Discussionmentioning

confidence: 99%

Sleep Duration Predicts Cardiometabolic Risk in Obese Adolescents

IglayReger

Peterson

Liu

et al. 2014

The Journal of Pediatrics

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Objective To examine the independent contributions of objectively measured sleep duration and fragmentation on cardiometabolic risk accumulation in free-living obese adolescents. Study design Characteristics of metabolic syndrome (waist circumference, mean arterial pressure, fasting high-density lipoprotein cholesterol, triglycerides, glucose) were measured in obese adolescents and standardized residuals(z-scores) were summed (inverse high-density lipoprotein cholesterol) to create a continuous cardiometabolic risk score (cMetScore), adjusted for age, sex, and race. Sleep and physical activity were objectively measured in habitual, free-living conditions for 7 days (SenseWear Pro3, BodyMedia, Pittsburgh, Pennsylvania; n = 37; 54% female, ages 11–17 years). Associations between sleep duration and cMetScore were assessed via multiple linear regression. Results Body mass index, total sleep time, and sleep session length were each correlated with cMetScore (P < .05 all). Total sleep time was inversely and independently associated with cMetScore (r = −0.535, P = .001) and was the best independent predictor of metabolic risk. Conclusions Sleep duration inversely predicts cardiometabolic risk in obese adolescents, even when we controlled for various measures of physical activity, anthropometry, and adiposity. Further research should investigate the biological mechanism of this relationship and the potential treatment effect of sleep intervention in decreasing cardiometabolic risk in this population.

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Does Sleep Duration Predict Metabolic Risk in Obese Adolescents Attending Tertiary Services? A Cross-Sectional Study

Cited by 46 publications

References 56 publications

Sleep characteristics and cardiovascular risk in children and adolescents: an enumerative review

Sleep characteristics and cardiovascular risk in children and adolescents: an enumerative review

Low Physical Activity Level and Short Sleep Duration Are Associated with an Increased Cardio-Metabolic Risk Profile: A Longitudinal Study in 8-11 Year Old Danish Children

Sleep Duration Predicts Cardiometabolic Risk in Obese Adolescents

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