Infant sleep problems and childhood overweight: Effects of three definitions of sleep problems

Abstract

Sleep problems have been defined using a variety of definitions. No study has assessed the longitudinal association between infant sleep problems and childhood overweight or obesity using existing definitions of sleep problems. This study used longitudinal data (n = 895) from the multi-site Study of Early Child Care and Youth Development (SECCYD) to investigate the effects of infant sleep problems on childhood weight status in Grade 6. Infants with sleep problems in Phase I (1991) and with complete data through Phase III (2004) of SECCYD were included. Sleep problems were assessed using maternal reports of night wakings and duration of a waking episode. Sleep problems were defined using Richman (1981), Lozoff et al. (1985), and Zuckerman et al. (1987) definitions. Multinomial logistic regression was used to examine the association between sleep problems during infancy and childhood weight status in Grade 6 while controlling for birth weight, race, sex, breastfeeding, maternal poverty, family structure, and maternal education. After adjusting for all covariates, children with a history of sleep problems were found to be overweight in Grade 6 using Zukerman et al. (Odds ratio (OR) = 1.68; 95% confidence interval (CI): 1.11–2.55) and Richman (OR = 1.76; 95% CI: 1.05–2.97) definitions, but not using Lozoff et al. definition. Infant sleep problems were not found to be associated with being obese. The study found differential effects of infant sleep problems on childhood overweight in Grade 6 per different definitions of sleep problems. Findings highlight the need to construct a single definition of infant sleep problems.

Sleep quality and obesity in young subjects: a meta‐analysis

“…A total of 18 studies discussed the association between sleep quality and BMI in children, adolescents, and young adults (Table ) . Among these, three were longitudinal studies , one was case‐control , and the remaining were cross‐sectional. The majority of studies were conducted in the USA (n = 6), followed by Canada (n = 3), the UK(n = 2), and the remaining were each from Brazil, Portugal, Norway, Taiwan, KSA, Belgium, and Malaysia.…”

“…The study participants ages ranged from <2 years to 34 years, and they came from diverse socioeconomic and ethnic backgrounds. Most of the studies explored the effect of only sleep quality while a few examined the combined effects of both quantity and quality of sleep on Ow/Ob outcome .…”

“…Though most of the studies used validated questionnaires to explore sleep quality, some relied on parent or self‐reports . The objective methods for sleep assessment were rarely used, with just three studies reporting the use of actigraphy .…”

“…The lowest scoring study had 12 points deducted while the highest scoring study had no points deducted resulting in a score of 17. There were ten studies comprising the middle two quartiles (scores 9 – 11) , two studies in the lowermost quartile (scores 5 – 7) and six studies in the uppermost quartile (scores 12 – 17) .…”

“…Of the deficits in bias safeguards, the most common was a lack of clarity about eligibility criteria, but a few studies did provide this information. Other deficits included not adjusting for the role of potential confounders However; all longitudinal studies accounted for missing data and compared the sample with complete data with the sample without complete data.…”