Sleep Issues Feed Childhood Obesity

Both sleep-disordered breathing (SDB) and short sleep duration significantly and independently increase the odds of children becoming overweight by age 15 years, according to a new study. This finding underscores the importance of early identification and remediation of these risk factors to reduce childhood obesity.

“These two risk factors had not been tracked together in children over time to determine their potential for independently influencing weight gain. Our study aimed to fill in that gap," said lead author Karen Bonuck, PhD, Professor of Family and Social Medicine and of Obstetrics & Gynecology and Women’s Health at Albert Einstein College of Medicine of Yeshiva University in New York.

Both SDB and short sleep duration are associated with childhood obesity. Mechanisms that link SDB to obesity-including inflammation and insulin resistance, appetite-regulating hormones, and sleep disruption-are multifactorial and complex and often have reciprocal effects. Short sleep duration also increases obesity risk in longitudinal data from early and middle childhood through adolescence. “In fact, increasing young children’s sleep is considered among the most promising strategies for reducing childhood obesity,” the researchers stated.

For their population-based cohort study, Dr Bonuck and her colleagues collected data from parent questionnaires on both child sleep duration and SDB symptoms from birth through 6.75 years and child body mass index data on nearly 1900 children.

The researchers found that children with the most severe SDB are at greatest risk for obesity. The children with the worst SDB symptoms were twice as likely to become obese by ages 7, 10, and 15 years as those in the asymptomatic group.

Children whose SDB peaked later, around age 5 to 6 years, fared better but still had a 60% to 80% increased risk of becoming obese.

Overall, one-fourth of children had an increased statistical risk of obesity that arose from SDB symptoms experienced earlier in life.

“Similarly, short sleep duration at around 5-6 years was associated with overweight at 15 years, independent of SDB,” the researchers stated.

They noted that SDB and lack of sleep were equally strong risk factors for obesity but their effects were independent of each other. The study did not analyze whether children affected by both of the sleep-related risk factors were at greater risk for obesity than children who had just 1 risk factor.

“Our research strengthens the case that insufficient sleep and SDB-especially when present early in childhood-increase the risk for becoming obese later in childhood,” said Dr Bonuck. She noted that despite the bright spotlight in recent years on the potential influence of insufficient sleep on obesity risk, “the potential contribution of untreated childhood SDB has received scant attention.”

If impaired sleep in childhood is conclusively shown to cause future obesity, it may be vital for physicians and parents to identify sleep problems early on so that corrective action can be taken and obesity prevented, the researchers stated.

They published their results online on December 10, 2014 in The Journal of Pediatrics.