Sleep and obesity among children: A systematic review of multiple sleep dimensions

Abstract

Summary The objectives were to systematically investigate the multiple dimensions of sleep and their association with overweight or obesity among primary school‐aged children. CINHAL, PsycINFO, SPORTDiscus, Medline, Cochrane, Embase, and PubMed databases were searched for papers reporting on an association between children's sleep and weight status. Studies on clinical populations, published in languages other than English, without objectively measured weight status, or where weight status was reported outside the outlined age bracket (5‐13 years) were excluded. A total of 34 248 citations were extracted from our systematic search protocol, of which 112 were included for detailed review. Compared with sleep duration, of which 86/103 articles found a significant inverse association between sleep duration and measured weight status, few studies examined other dimensions of sleep, such as quality, efficiency and bed/wake times, and relationship with weight status. Where studies existed, variation in defining and measurement of these dimensions restricted comparison and potentially influenced discrepancies across results. Overall, the findings of this review warrant the need for further research of the outlined dimensions of sleep. Future research would benefit from clarity on definitions across the different dimensions, along with the use of valid and reliable tools.

How do short sleepers use extra waking hours? A compositional analysis of 24-h time-use patterns among children and adolescents

“…Sufficient sleep is essential for physical and mental health [ 1 ]. Research has shown that short sleep duration is a risk factor for obesity and poor cardiometabolic health in the pediatric population [ 2 – 5 ]. Additionally, getting enough sleep is associated with enhanced emotional regulation, academic achievement and well-being of children and adolescents [ 6 , 7 ].…”

Associations of diarised sleep onset time, period and duration with total and central adiposity in a biethnic sample of young children: the Born in Bradford study

“…A recent review concluded that sleep timing, in particular later bedtimes, is associated with higher weight status in primary school-aged children [9]. Similarly, the few studies conducted thus far in 4 to 5 year olds indicate that later bedtimes, and most markedly bedtimes after 9pm, are associated with higher BMI z-score and obesity risk [5][6][7]; one study found that an association of short sleep with higher BMI z-score was only evident in children who went to bed after 9pm [8].…”

“…Aspects of sleep timing include bedtimes, time of sleep onset, and variability in sleeping pattern such as differences between weekday and weekend sleep schedules. Preliminary evidence indicates that later bedtimes are associated with higher weight status in preschoolers [5][6][7][8] and primary school-aged children [9], and that later sleep timing on weekends than weekdays is correlated with higher risk of overweight and obesity [10].…”

Elements of Effective Population Surveillance Systems for Monitoring Obesity in School Aged Children

“…Recommended amounts of sleep differ between age groups and also between countries; for example, the American Academy of Pediatrics recommends between 9 and 12 h per 24 h period for children aged 6 to 12 years and 8 to 10 h for adolescents aged 13–18 years [ 85 ], whereas Australian guidelines recommend 9 to 11 h of sleep per night for those aged 5–13 years and 8 to 10 h per night for those aged 14–17 years [ 50 ]. Some limited evidence suggests that measurement of “timing of sleep”, such as bed time and wake time may also be important, and a recent systematic review [ 86 ] has also drawn attention to other dimensions of sleep, such as sleep quality and sleep efficiency, but there is no internationally accepted definition of these variables.…”