Does Sleep Duration Predict Metabolic Risk in Obese Adolescents Attending Tertiary Services? A Cross-Sectional Study

Centre for Community Child Health, Royal Children’s Hospital and Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia.
Sleep (Impact Factor: 4.59). 07/2011; 34(7):891-8. DOI: 10.5665/SLEEP.1122
Source: PubMed


To determine, in a clinical sample of obese adolescents, whether shorter sleep duration is associated with metabolic risk and obesity severity.
Cross-sectional study.
Tertiary care weight-management clinic in Cincinnati, OH, USA.
133 obese adolescents aged 10-16.9 years.
Multifaceted sleep duration data were examined with fasting venipuncture and anthropometric data collected during clinical care. Primary Outcome: presence of metabolic syndrome. Secondary Outcomes: waist circumference, triglycerides, HDL-cholesterol, blood pressure, glucose, insulin resistance (HOMA-IR), and body mass index (BMI). Predictors: Sleep duration by (1) parent-report, (2) self-report, and (3) multi-night actigraphy. Analysis: Relationships between sleep duration and each outcome were examined via regression models, adjusted for potential confounders.
Regardless of how measured, sleep duration showed no strong association with metabolic syndrome (OR 1.1 to 1.5, P = 0.2 to 0.8), BMI (β -0.03 to -0.01, P = 0.2 to 0.8), or most other outcomes. Lower triglycerides were predicted by shorter sleep duration by self-report (β 12.3, P = 0.01) and actigraphy (β 13.6, P = 0.03), and shorter parent-reported sleep duration was associated with higher HDL-cholesterol (β = -2.7, P = 0.002).
Contrary to expectations, sleep duration was not associated with metabolic outcomes, and showed limited associations with lipid profiles. Although inadequate sleep may affect other areas of functioning, it appears premature to expect that lengthening sleep will improve BMI or metabolic outcomes in clinical samples of obese adolescents.

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    • "In addition, insufficient sleep is associated with poor impulse control, risk-taking behaviors, and other cognitive and psychological deficits (Beebe, 2011; Carskadon, Acebo, & Jenni, 2004; Roberts, Roberts, & Xing, 2011) that may contribute to weight gain. Other reports, however, suggest that short sleep may not independently influence obesity (Olds, Maher, & Ridley, 2011; Sung et al., 2011). For instance, Olds and colleagues' naturalistic longitudinal study found that later bedtimes and wake times—but not sleep duration—were associated with reduced physical activity and higher weight (2011). "
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    ABSTRACT: We hypothesized that shorter sleep durations and greater variability in sleep patterns are associated with weight gain in the first semester of university. Students (N = 132) completed daily sleep diaries for 9 weeks, completed the MEQ (chronotype) and CES-D (depressed mood) at week 9, and self-reported weight/height (weeks 1 & 9). Mean and variability scores were calculated for sleep duration (TST, TSTv), bedtime (BT, BTv), and wake time (WT, WTv). An initial hierarchical regression evaluated (block 1) sex, ethnicity; (block 2) depressed mood, chronotype; (block 3) TST; (block 4) BT, WT; and (block 5; R(R) change = 0.09, p = 0.005) TSTv, BTv, WTv with weight change. A sex-by-TSTv interaction was found. A final model showed that ethnicity, TST, TSTv, and BTv accounted for 31% of the variance in weight change for males; TSTv was the most significant contributor (R(R) change = 0.21, p < 0.001). Daily variability in sleep duration contributes to males' weight gain. Further investigation needs to examine sex-specific outcomes for sleep and weight.
    Behavioral Sleep Medicine 08/2014; DOI:10.1080/15402002.2014.940109 · 2.34 Impact Factor
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    • "In addition, a stronger inverse association was reported between sleep duration and BMI and WC in male but not in female Australian children and adolescents (Eisenmann et al., 2006). Also, sleep duration showed no strong association with metabolic syndrome or BMI in obese adolescents from Australia (Sung et al., 2011). "
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    ABSTRACT: Abstract Background: Numerous studies have shown significant associations between short sleep duration and overall or abdominal obesity. However, no study has reported on the joint association of body mass index (BMI) and waist-to-height ratio (WHtR) with sleep duration in adolescents. Aim: To examine the joint associations of BMI and WHtR with sleep duration among Saudi adolescents. Subjects and methods: A school-based cross-sectional study was conducted involving 2852 secondary-school students (51.7% females) aged 15-19 years, randomly selected using a multistage stratified cluster sampling. Self-reported sleep duration was assessed and BMI was classified into high and low categories according to the IOTF classification, whereas WHtR categories were based on above and below 0.5. Results: The low BMI-low WHtR category had the longest mean sleep duration (7.27 hours/day), whereas the high BMI-high WHtR group had the shortest sleep duration (7.02 hours/day; p = 0.003) (aOR = 0.832, 95% CI = 0.698-0.992, p = 0.040). In addition, high BMI-low WHtR or low BMI-high WHtR groups didn't significantly associate with reduced sleep duration among adolescents. Conclusion: The joint association of high BMI-high WHtR increases adolescent's risk of having reduced sleep duration. Future research should seek to confirm such findings and provide an explanation for this association.
    Annals of Human Biology 10/2013; 41(2). DOI:10.3109/03014460.2013.833291 · 1.27 Impact Factor
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    • "In contrast to an earlier published study [62], our research found no differences in the prevalence of obesity or neck and waist circumference across groups of different sleep duration. Obesity has been reported to increase when sleep duration was either more or less than 7 to 8 h; however, such findings are inconsistent and sleep duration has not been proven to be a potentially modifiable factor for obesity [63] [64]. "
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    ABSTRACT: We aimed to describe the distribution of self-reported sleep duration in adults over the age of 40years and to analyze the associated risk factors, comorbid conditions, and quality of life (QoL). Our study was constructed as a cross-sectional population-based study and is part of the PLATINO (Spanish acronym for the Latin American Project for Research in Pulmonary Obstruction) study. It includes data from Mexico City (Mexico), Montevideo (Uruguay), Santiago (Chile), and Caracas (Venezuela). Data from 4533 individuals were analyzed using a single questionnaire entitled, PLATINO, which was designed to collect data on self-reported sleep symptoms. Spirometry also was performed in accordance with international standards. All statistical analyses took the study design into consideration with adjustments for each city. The prevalence of subjects who reported sleeping <7h was 38.4%, ⩾7 to <9h was 51.4%, and ⩾9h was 10.2%. In the multivariate analysis, individuals with shorter sleep duration had higher frequencies of insomnia, increased forced expiratory volume in one second in liters and percentage/forced vital capacity in liters (FEV1/FVC) of predicted ratios, and a higher presence of coughing and phlegm. The main risk factor associated with longer duration of sleep was the number of comorbidities. Self-reported sleep duration discriminated among groups that differed in sleep-related symptoms, respiratory symptoms, QoL and comorbid conditions.
    Sleep Medicine 07/2013; 14(9). DOI:10.1016/j.sleep.2013.04.014 · 3.15 Impact Factor
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