Sleep and Obesity in Preschool Children

Department of Child Development and Behavior, Shanghai Children's Medical Center, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China.
The Journal of pediatrics (Impact Factor: 3.79). 02/2009; 154(6):814-8. DOI: 10.1016/j.jpeds.2008.12.043
Source: PubMed


To examine the relationship between sleep and obesity in children 3 to 4 years old in Shanghai, China.
A total of 1311 Chinese children from 10 kindergarten classes in Shanghai, aged 3 to 4 years, who were participating in the kindergarten entrance health examination in 2000, were included in the study. Body weight and height were measured, and a questionnaire was given to the children's parents about sleep and physical and social characteristics of the children and their family. The main outcome measure was obesity, defined as body mass index (kg/m2) > or = 95th percentile for the children.
Compared with children reporting > or = 11 hours of sleep per night, the odds ratio for childhood obesity was 4.76 (95% CI, 1.28-17.69) for children with <9 hours of sleep, and 3.42 (95% CI, 1.12-10.46) for children with 9.0 to 9.4 hours of sleep, after adjustment for age, sex, and other risk factors. Children with caregivers who slept less, who had mothers with higher education, or who co-slept with caregivers had less nighttime sleep than other children.
Short sleep duration is positively associated with obesity in preschool children, and short nighttime sleep duration is significantly related to bedtime and co-sleeping with caregivers.

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    • "Sleep problems in early childhood are common, affecting approximately 15–30% of preschool-aged children and are persistent over time into later childhood and adolescence [1] [2]. A large body of research has established concurrent associations between early sleep problems and impairments across multiple domains, including cognitive and behavioral deficits, poor academic and social functioning, and decreased physical health [3] [4] [5]. Moreover, increasing evidence has linked early childhood sleep problems to difficulties with emotion regulation, internalizing and externalizing disorders, even in prospective, longitudinal studies [2,6–8]. "
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    ABSTRACT: Study objectives Using a multi-method design, this study examined the construct validity of the Parent-Child Sleep Interactions Scale (PSIS; Alfano et al., 2013), which measures sleep-related parenting behaviors and interactions that contribute to preschoolers’ sleep problems. Methods Participants included a community sample of 155 preschoolers (ages 3-5 years; 51.6% female). Primary caregivers completed the PSIS. Parenting styles and behaviors were assessed with laboratory observations and parent-report. Parent and child psychopathology and family life stress were assessed with clinical interviews and parent-report. Results Bivariate correlations revealed significant associations between the PSIS and a number of variables, including lower observed parental support and quality of instruction; higher observed parental intrusiveness; authoritative, authoritarian, and permissive parenting styles; current maternal depressive and/or anxiety disorders and depressive symptomatology; increased stressful life events; lower marital satisfaction; higher child depressive, anxiety, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) symptoms. Patterns of association varied based on the specific PSIS scale. Conclusions The PSIS demonstrates meaningful associations with parenting, maternal psychopathology, family stress, and child psychopathology and functioning. Findings suggest that the PSIS is a valid measure for assessing sleep-related parent/child behaviors and interactions among preschoolers, suited to real world settings.
    Full-text · Article · Aug 2014 · Sleep Medicine
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    • "Our data are similar to those reported in New Zealand children, in which the average amount of sleep was 11 hours (Carter et al., 2011). Both high TV exposure and short sleep duration individually have been linked with obesity, even in young children (Agras et al., 2004; Jago et al., 2005; Jiang et al., 2009). Further, short sleep duration (59 hours) was independently associated with hypertension among Chinese boys age 11–14 years old (Guo et al., 2011); in pre-school ages the data so far showed that total ST was correlated with SBP (Sampei et al., 2006), as found in our study. "
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    ABSTRACT: Aim: The aim of this study was to examine the association between sleeping time (SLT), time spent using screen (ST) and weight status with Systolic Blood Pressure (SBP) among pre-school children. Subjects and methods: The sample comprised 628 pre-school children (50% female), aged 3-6 years-old. SLT and ST were reported by parents. BMI values were categorized according to IOTF. SBP cut points were based on SBP percentiles for age, sex and height. ST was dichotomized according to the following criteria: ≤1 hour vs >1 hour and SLT: ≤10.5 hours vs >10.5 hours. Participants were then categorized into one of four category profiles: Low ST/High SLT; High ST/Low SLT; Low ST/Low SLT and High ST/High SLT. Results: Children assigned to the High ST/Low SLT group were 2-times more likely to have high SBP values compared to those who were assigned to the Low ST/High SLT group (OR = 2.4; 95% CI = 1.1-5.1). Furthermore, those who were assigned as overweight and obese were more likely to be classified as having elevated BP (OR = 1.8; 95% CI = 1.1-3.2 for overweight and OR = 3.1; 95% CI = 1.6-5.8 for obese, respectively). Conclusion: The data showed that high ST exposure time and low SLT are associated with enhanced blood pressure in children at pre-school.
    Full-text · Article · May 2014 · Annals of Human Biology
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    • "This study found that children who sleep less than normal amounts have higher odds of being overweight and obese. Despite many studies reporting a significant U shape relationship in which both short sleepers and long sleepers tend to gain weight [15] [16] [31] [32], one study reported such a relationship were found only in obese not in overweight children [17]. Longitudinal analysis of the same cohort revealed that short sleepers had an increased risk of weight gain [33] and a weak association was reported [34]. "
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    ABSTRACT: Objective This study aimed to determine the association between sleep habits (including bedtime, wake up time, sleep duration, and sleep disorder score) and physical characteristics, physical activity level, and food pattern in overweight and obese versus normal weight children. Design Case control study. Subjects 164 Malaysian boys and girls aged 6–12 years. Methods Anthropometric measurements included weight, height, waist circumference, and body fat percentage. Subjects divided into normal weight (n = 82) and overweight/obese (n = 82) group based on World Health Organization 2007 BMI-for-age criteria and were matched one by one based on ethnicity, gender, and age plus minus one year. Questionnaires related to sleep habits, physical activity, and food frequency were proxy-reported by parents. Sleep disorder score was measured by Children Sleep Habit Questionnaire. Results Sleep disorder score and carbohydrate intake (%) to total energy intake were significantly higher in overweight/obese group (p < 0.01 and p < 0.05, respectively). After adjusting for age and gender, sleep disorder score was correlated with BMI (r = 0.275, p < 0.001), weight (r = 0.253, p < 0.001), and WC (r = 0.293, p < 0.001). Based on adjusted odd ratio, children with shortest sleep duration were found to have 4.5 times higher odds of being overweight/obese (odd ratio: 4.536, 95% CI: 1.912–8.898) compared to children with normal sleep duration. The odds of being overweight/obese in children with sleep disorder score higher than 48 were 2.17 times more than children with sleep disorder score less than 48. Conclusion Children who sleep lees than normal amount, had poor sleep quality, and consumed more carbohydrates were at higher risk of overweight/obesity.
    Full-text · Article · Feb 2014 · Obesity Research & Clinical Practice
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