Sleep-Disordered Breathing, Sleep Duration, and Childhood Overweight: A Longitudinal Cohort Study

Abstract

Objectives To examine independent associations between sleep-disordered breathing (SDB), sleep duration from birth through 6.75 years, and body mass index (BMI) through 15 years of age in a population-based cohort. Study design The Avon Longitudinal Study of Parents and Children (ALSPAC) collected parent questionnaire data on child sleep duration and sleep disordered breathing (SDB) symptoms from birth through 6.75 years and child BMI from ALSPAC research clinics (n=1,899). For SDB, logistic regression models-- minimal, confounder, and confounder + sleep duration adjusted-- examined associations with BMI at 7, 10, and 15 years. For short sleep duration (≤ 10th centile), comparable SDB-adjusted models examined associations with BMI at 15 years. Results Children with the worst SDB symptoms vs. asymptomatic children, had increased odds of overweight at 7 (OR=2.08, 95% CI= 1.04-4.17), 10 (OR= 1.79, 95% CI= 1.02-3.16), and 15 years (OR= 2.25, 95% CI= 1.27-3.97) in models adjusted for sleep duration. Similarly, short sleep duration at ≈5-6 years was associated with overweight at 15 years, independent of SDB. Children with short sleep duration at 4.75 years were more likely to be overweight at 15 years in minimally (OR= 2.21, 95% CI= 1.52-3.20), confounder (OR= 1.99, 95% CI= 1.34-2.96), and SDB-adjusted (OR= 2.04, 95% CI= 1.36=3.04) models. Conclusion Both SDB and short sleep duration significantly and independently increase children’s odds of becoming overweight. Findings underscore the potential importance of early identification and remediation of SDB, along with insufficient sleep, as strategies for reducing childhood obesity.

Obesity and Altered Sleep: A Pathway to Metabolic Derangements in Children?

“…Those findings underscore the potential importance of early identification and remediation of any sleep disturbance, as minimal as it may seem, as a potentially viable strategic approach for reducing childhood obesity. [63]. In summary, identification of children at risk during infancy and early childhood by periodic assessments of sleep duration, regularity or onset of sleep disorders, along with prospective interventions aiming to prolong and regularize sleep in such children should provide us with more definitive answers as to the role of sleep in the context of BMI regulation and metabolic homeostasis during the formative childhood years.…”

Current child, but not maternal, snoring is bi-directionally related to adiposity and cardiometabolic risk markers: A cross-sectional and a prospective cohort analysis

“…In one study, children with the highest levels of sleep-disordered breathing versus those without any OSA showed higher risk of later becoming overweight [20]. In another study, OSA was related to higher diastolic and systolic blood pressure values but not changes in blood pressure after four years [49].…”

“…A few prospective studies have looked at only inflammation and overweight/obesity in association with snoring and OSA, but not in-depth the complete spectrum of cardiometabolic biomarkers [20,21]. For instance, OSA in obese children was associated with greater visceral fat area derived using MRI [22].…”

Association of sleep disordered breathing symptoms with early postoperative analgesic requirement in pediatric ambulatory surgical patients

“…The confounding effect of obesity on our results should also be considered because obesity is strongly associated with SDB/OSA (27) and OSA appears to amplify the underlying systemic inflammation that is present in obesity (28). As in previous studies (27), we found that children with SDB symptoms were more likely to be overweight or obese.…”