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Journal of Pediatric Biochemistry 2016; 06(04): 179-183
DOI: 10.1055/s-0037-1598612
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Sleep Duration and Obesity

Rosalia Silvestri
1   Department of Clinical and Experimental Medicine, Sleep Medicine Center, Gazzi, Italy
,
Irene Aricò
1   Department of Clinical and Experimental Medicine, Sleep Medicine Center, Gazzi, Italy
› Author Affiliations
Further Information

Publication History

28 November 2016

09 December 2016

Publication Date:
14 February 2017 (online)

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Abstract

Reduced sleep duration has an almost linear correlation with excessive weight and obesity in the pediatric population. This is especially true for the youngest population, less so for adolescents, whereas later on, this relationship tends to become U-shaped in middle-aged subjects. The level of physical activity is a crucial determinant of this correlation, with sedentary life and low activity level supporting obesity and poor quality sleep. Quality of life, school achievement, and emotional regulation are highly impacted by the short sleep–excessive weight dyad, as well as cardiometabolic indexes. The latter include blood pressure, glucose metabolism, and lipid profile, which all appear to be negatively affected, albeit less consistently, and thus with low quality evidence as far as the latest meta-analytic reviews are concerned. Obstructive sleep apnea (OSA) in children is also associated with alteration of sleep structure and with sleep fragmentation rather than sleep time reduction. Pediatric OSA recognizes two main phenotypes, lean and obese, the latter mostly typical of older children/adolescents, mainly males, with a more severe impact on inflammatory and metabolic indexes and a scarce cure rate after therapeutic adenotonsillectomy. Expanding sleep time and limiting obesity with appropriate sleep hygiene, adequate exercise levels, salutary nutritional advice, and screen time reduction may represent viable preventive tools to avoid more serious physical and mental consequences later in adult life.

Keywords

sleep duration - obesity - physical activity - insulin resistance - pediatric OSA
 

  • References

  • 1 Berger RJ, Phillips NH. Energy conservation and sleep. Behav Brain Res 1995; 69 (1-2): 65-73
    CrossrefPubMedSearch in Google Scholar
  • 2 Dinges D, Chugh DK. Physiologic correlates of sleep deprivation. In: Kinney JM, Tucker HN, , eds. Physiology, Stress, and Malnutrition: Functional Correlates, Nutritional Intervention. New York, NY: Lippincott-Raven; 1997: 1-27
    Search in Google Scholar
  • 3 Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med 2004; 1 (3) e62 . Doi: 10.1371/journal.pmed.0010062
    CrossrefPubMedSearch in Google Scholar
  • 4 Spiegel K, Tasali E, Penev P, Van Cauter E. Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004; 141 (11) 846-850
    CrossrefPubMedSearch in Google Scholar
  • 5 Kripke DF, Garfinkel L, Wingard DL, Klauber MR, Marler MR. Mortality associated with sleep duration and insomnia. Arch Gen Psychiatry 2002; 59 (2) 131-136
    CrossrefPubMedSearch in Google Scholar
  • 6 Chaput JP, Després JP, Bouchard C, Tremblay A. Short sleep duration is associated with reduced leptin levels and increased adiposity: results from the Quebec family study. Obesity (Silver Spring) 2007; 15 (1) 253-261
    CrossrefPubMedSearch in Google Scholar
  • 7 Rea CJ, Smith RL, Taveras EM. Associations of parent health behaviors and parenting practices with sleep duration in overweight and obese children. J Clin Sleep Med 2016; 12 (11) 1493-1498
    PubMedSearch in Google Scholar
  • 8 Fatima Y, Doi SAR, Mamun AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obes Rev 2015; 16 (2) 137-149
    CrossrefPubMedSearch in Google Scholar
  • 9 Sleep Health Foundation. Sleep needs across the lifespan. Available at http://www.sleephealthfoundation.org.au/ . Published February 2015 . Accessed November 2016
    PubMedSearch in Google Scholar
  • 10 National Sleep Foundation. Sleep in America poll. Available at http://www.sleepfoundation.org . Published 2013 . Accessed November 2016
    PubMedSearch in Google Scholar
  • 11 National Institute of Health. How much sleep is enough?. Available at https://www.nhlbi.nih.gov/health/health-topics/topics/sdd/howmuch . Published February 22, 2012 . Accessed November 2016
    PubMedSearch in Google Scholar
  • 12 Seegers V, Petit D, Falissard B , et al. Short sleep duration and body mass index: a prospective longitudinal study in preadolescence. Am J Epidemiol 2011; 173 (6) 621-629
    CrossrefPubMedSearch in Google Scholar
  • 13 Marshall NS, Glozier N, Grunstein RR. Is sleep duration related to obesity? A critical review of the epidemiological evidence. Sleep Med Rev 2008; 12 (4) 289-298
    CrossrefPubMedSearch in Google Scholar
  • 14 Agras WS, Hammer LD, McNicholas F, Kraemer HC. Risk factors for childhood overweight: a prospective study from birth to 9.5 years. J Pediatr 2004; 145 (1) 20-25
    CrossrefPubMedSearch in Google Scholar
  • 15 Dieu HTT, Dibley MJ, Sibbritt D, Hanh TTM. Prevalence of overweight and obesity in preschool children and associated socio-demographic factors in Ho Chi Minh City, Vietnam. Int J Pediatr Obes 2007; 2 (1) 40-50
    CrossrefPubMedSearch in Google Scholar
  • 16 Reilly JJ, Armstrong J, Dorosty AR , et al; Avon Longitudinal Study of Parents and Children Study Team. Early life risk factors for obesity in childhood: cohort study. BMJ 2005; 330 (7504): 1357 . Doi: 10.1136/bmj.38470.670903.E0
    CrossrefPubMedSearch in Google Scholar
  • 17 Snell EK, Adam EK, Duncan GJ. Sleep and the body mass index and overweight status of children and adolescents. Child Dev 2007; 78 (1) 309-323
    CrossrefPubMedSearch in Google Scholar
  • 18 Grandner MA, Schopfer EA, Sands-Lincoln M, Jackson N, Malhotra A. Relationship between sleep duration and body mass index depends on age. Obesity (Silver Spring) 2015; 23 (12) 2491-2498
    CrossrefPubMedSearch in Google Scholar
  • 19 Grandner MA, Martin JL, Patel NP , et al. Age and sleep disturbances among American men and women: data from the U.S. Behavioral Risk Factor Surveillance System. Sleep 2012; 35 (3) 395-406
    PubMedSearch in Google Scholar
  • 20 Chaput JP, Lambert M, Gray-Donald K , et al. Short sleep duration is independently associated with overweight and obesity in Quebec children. Can J Public Health 2011; 102 (5) 369-374
    CrossrefPubMedSearch in Google Scholar
  • 21 Morrissey B, Malakellis M, Whelan J , et al. Sleep duration and risk of obesity among a sample of Victorian school children. BMC Public Health 2016; 16: 245 . Doi: 10.1186/s12889-016-2913-4
    CrossrefPubMedSearch in Google Scholar
  • 22 Mcneil J, Tremblay MS, Leduc G , et al. Objectively-measured sleep and its association with adiposity and physical activity in a sample of Canadian children. J Sleep Res 2015; 24 (2) 131-139
    CrossrefPubMedSearch in Google Scholar
  • 23 Stone MR, Stevens D, Faulkner GE. Maintaining recommended sleep throughout the week is associated with increased physical activity in children. Prev Med 2013; 56 (2) 112-117
    CrossrefPubMedSearch in Google Scholar
  • 24 Ekstedt M, Nyberg G, Ingre M, Ekblom Ö, Marcus C. Sleep, physical activity and BMI in six to ten-year-old children measured by accelerometry: a cross-sectional study. Int J Behav Nutr Phys Act 2013; 10 (1) 82 . Doi: 10.1186/1479-5868-10-82
    CrossrefPubMedSearch in Google Scholar
  • 25 Carson V, Tremblay MS, Chaput JP, Chastin SF. Associations between sleep duration, sedentary time, physical activity, and health indicators among Canadian children and youth using compositional analyses. Appl Physiol Nutr Metab 2016; 41 (6, Suppl 3): S294-S302
    CrossrefPubMedSearch in Google Scholar
  • 26 Carson V, Hunter S, Kuzik N , et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Appl Physiol Nutr Metab 2016; 41 (6, Suppl 3): S240-S265
    CrossrefPubMedSearch in Google Scholar
  • 27 Brocklebank LA, Falconer CL, Page AS, Perry R, Cooper AR. Accelerometer-measured sedentary time and cardiometabolic biomarkers: a systematic review. Prev Med 2015; 76: 92-102
    CrossrefPubMedSearch in Google Scholar
  • 28 Chaput JP, Gray CE, Poitras VJ , et al. Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth. Appl Physiol Nutr Metab 2016; 41 (6, Suppl 3): S266-S282
    CrossrefPubMedSearch in Google Scholar
  • 29 Marrone O, Bonsignore MR. The puzzle of metabolic effects of obstructive sleep apnoea in children. Eur Respir J 2016; 47 (4) 1050-1053
    CrossrefPubMedSearch in Google Scholar
  • 30 Koren D, Gozal D, Philby MF, Bhattacharjee R, Kheirandish-Gozal L. Impact of obstructive sleep apnoea on insulin resistance in nonobese and obese children. Eur Respir J 2016; 47 (4) 1152-1161
    CrossrefPubMedSearch in Google Scholar
  • 31 Bhushan B, Maddalozzo J, Sheldon SH , et al. Metabolic alterations in children with obstructive sleep apnea. Int J Pediatr Otorhinolaryngol 2014; 78 (5) 854-859
    CrossrefPubMedSearch in Google Scholar
  • 32 Hannon TS, Lee S, Chakravorty S, Lin Y, Arslanian SA. Sleep-disordered breathing in obese adolescents is associated with visceral adiposity and markers of insulin resistance. Int J Pediatr Obes 2011; 6 (2) 157-160
    CrossrefPubMedSearch in Google Scholar
  • 33 Caminiti C, Evangelista P, Leske V, Loto Y, Mazza C. Obstructive sleep apneas in symptomatic obese children: polisomnographic confirmation and its association with disturbances in carbohydrate metabolism [in Spanish]. Arch Argent Pediatr 2010; 108 (3) 226-233
    PubMedSearch in Google Scholar
  • 34 Li AM, Chan MH, Chan DF , et al. Insulin and obstructive sleep apnea in obese Chinese children. Pediatr Pulmonol 2006; 41 (12) 1175-1181
    CrossrefPubMedSearch in Google Scholar
  • 35 Flint J, Kothare SV, Zihlif M , et al. Association between inadequate sleep and insulin resistance in obese children. J Pediatr 2007; 150 (4) 364-369
    CrossrefPubMedSearch in Google Scholar
  • 36 Stefanini DO, Barros EL, Stefanini R, Pradella-Hallinan ML, Pignatari SS, Fujita RR. Comparing the clinical profile of non obese children with sleep apnea and snoring. Rev Bras Otorrinolaringol (Engl Ed) 2012; 78 (5) 22-26
    PubMedSearch in Google Scholar
  • 37 Suri JC, Sen MK, Sharma R, Chakrabarti S, Mir E, Adhikari T. Metabolic changes in normal- and underweight children with obstructive sleep-disordered breathing. Sleep Med 2015; 16 (11) 1366-1371
    CrossrefPubMedSearch in Google Scholar
  • 38 Kaditis AG, Alexopoulos EI, Damani E , et al. Obstructive sleep-disordered breathing and fasting insulin levels in nonobese children. Pediatr Pulmonol 2005; 40 (6) 515-523
    CrossrefPubMedSearch in Google Scholar
  • 39 Bhushan B, Ayub B, Loghmanee DA, Billings KR. Metabolic alterations in adolescents with obstructive sleep apnea. Int J Pediatr Otorhinolaryngol 2015; 79 (12) 2368-2373
    CrossrefPubMedSearch in Google Scholar
  • 40 Redline S, Storfer-Isser A, Rosen CL , et al. Association between metabolic syndrome and sleep-disordered breathing in adolescents. Am J Respir Crit Care Med 2007; 176 (4) 401-408
    CrossrefPubMedSearch in Google Scholar
  • 41 Koren D, Gozal D, Bhattacharjee R, Philby MF, Kheirandish-Gozal L. Impact of adenotonsillectomy on insulin resistance and lipoprotein profile in nonobese and obese children. Chest 2016; 149 (4) 999-1010
    CrossrefPubMedSearch in Google Scholar
  • 42 Quante M, Wang R, Weng J , et al; Childhood Adenotonsillectomy Trial (CHAT). The effect of adenotonsillectomy for childhood sleep apnea on cardiometabolic measures. Sleep 2015; 38 (9) 1395-1403
    CrossrefPubMedSearch in Google Scholar