Sleep duration and bedtime in preschool‐age children with obesity: Relation to BMI and diet following a weight management intervention

Abstract

Summary Background Sleep duration is associated with obesity in preschoolers. Weight‐management interventions may be an opportunity to incorporate sleep health recommendations. Objectives To examine changes in sleep in preschool‐age children with obesity following a family‐based weight‐management intervention (Learning about Activity and Understanding Nutrition for Child Health [LAUNCH]) compared with motivational interviewing and standard care conditions. Additionally, we examined associations between sleep with body mass index (BMI) z score (BMIz) and diet. Methods One hundred fifty‐one children (4.6 ± 0.93 y) completed baseline (pretreatment) and posttreatment (week 24) assessments, including anthropometrics, 24‐hour dietary recalls, and a 7‐day sleep diary. Analysis of variance (ANOVA) and chi‐squared tests compared sleep variables between groups; linear regression models examined effects of sleep on BMIz and dietary intake at posttreatment, controlling for baseline values. Results Bedtime and sleep duration were not significantly different between treatment groups from baseline to posttreatment. After adjusting for baseline sleep, earlier bedtime was associated with lower BMIz (95% CI, 0.00‐0.04; .03), intake of added sugars (95% CI, 0.70‐4.32; .007), and sweet/dessert food servings (95% CI, 0.00‐0.19; .04) at posttreatment. Longer night‐time sleep duration was associated with fewer added sugars at posttreatment, adjusting for baseline sleep (95% CI, −3.79 to −0.35; .02). Conclusions More comprehensive sleep intervention incorporated into weight‐management intervention may be necessary to promote positive changes for preschoolers with obesity. A focus on earlier bedtime and longer sleep duration appears to be important given associations between sleep duration and bedtime with BMIz and dietary intake.

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

“…Parents of South Asian children could be encouraged to set an earlier evening meal, an earlier sleep onset time, and to uphold consistent sleep schedules across week and weekend days. Studies of 4 to 5 year olds indicate that bedtimes before 9pm are important [5][6][7][8]. Our data also suggest that a reasonable and achievable target for young South Asian children might be a sleep onset time before 9pm.…”

“…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]. Just one study to date has been performed in younger children.…”

“…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].…”

Sleep‐wake patterns in newborns are associated with infant rapid weight gain and incident adiposity in toddlerhood

“…Sleep‐wake timing and circadian rhythmicity appear to play important roles in obesity risk, as variation in sleep schedules has been found to have a stronger influence on metabolism than total sleep duration 25 . Later bedtimes and greater variability in sleep schedules are predictive of greater changes in weight 26‐28 which are also associated with negative metabolic outcomes 29 . Infant growth is also impacted by sleep‐wake patterns.…”

<p>Children’s Sleep May Depend on Maternal Sleep Duration During Pregnancy: A Retrospective Study</p>

“…[2][3][4][5] It has been confirmed by accumulating studies that short sleep duration and sleep disturbance have negative impacts upon a range of aspects including metabolic balance, neurobehavioral function, and mental health. [2][3][4][5][6][7] To date, a large number of factors have been reported affect children's sleep. However, almost all studies focused on children's own environmental exposure, lifestyle factors, and health condition, such as family members' interaction, sleep environment, physical activity, obesity, etc.…”