Sleep-related breathing problems and chronic lack of sleep may each
double the risk of a child becoming obese by age 15, according to new
research from Albert Einstein College of Medicine of Yeshiva University.
The good news is that both sleep problems can be corrected. The study,
which followed nearly 2,000 children for 15 years, published online
today in The Journal of Pediatrics.
"In recent years, lack of sleep has become a well-recognized risk for
childhood obesity," said Karen Bonuck, Ph.D., professor of family and
social medicine and of obstetrics & gynecology and women's health at
Einstein and lead author on the paper. "Sleep-disordered breathing, or
SDB, which includes snoring and sleep apnea, is also a risk factor for
obesity but receives less attention. 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."
Dr. Bonuck and her colleagues used data collected on 1,899 children
by the Avon Longitudinal Study of Parents and Children (ALSPAC) based in
Avon, England. ALSPAC collected parent questionnaire data on both child
sleep duration and SDB symptoms from birth through 6.75 years and child
BMI data from research ALSPAC clinics.
Sleep-disordered breathing The researchers found
that children with the most severe SDB had the greatest risk for
obesity. Those children who fell into the "worst case" SDB category were
twice as likely to become obese by 7, 10 and 15 years of age, compared
to the asymptomatic group. Children considered "worst case" scored
highest for SDB symptoms of snoring, sleep apnea or mouth-breathing.
Children whose SDB peaked later, around 5 to 6 years old, fared better
but still had a 60 to 80 percent increased risk of becoming obese.
Overall, one-fourth of children in this population-based cohort had an
increased statistical risk of obesity that arose from SDB symptoms
experienced earlier in life. Obesity was defined as BMI greater than the
95th percentile for age and gender, according to the International
Obesity Task Force.
Sleep duration With respect to sleep duration,
children with the shortest sleep time at approximately 5 and 6 years of
age had a 60 to 100 percent increased risk of being obese at 15 years.
Children with short sleep duration at other ages saw no significant
increase in risk. (In this study, children with short sleep duration
were those who, in any given age group, slept less than 90 percent of
their peers. For those aged 5 and 6 years old, this was 10.5 hours a
night or less.)
Interestingly, SDB and lack of sleep were equally strong risk factors
for obesity, but their effects were independent of each other. The
researchers looked for associations between short-sleep-duration
children and SDB children across all age groups included in the study
but did not find clustering, i.e., there was little evidence that
children with one risk factor were more likely to also be affected by
the other. The study did not analyze whether children affected by both
of the sleep-related risk factors were at greater risk for obesity than
were children who had just one risk factor.
Addressing the Problem "We know that the road to
obesity often begins early in life," said Dr. Bonuck. "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. If impaired sleep in childhood is conclusively shown to
cause future obesity, it may be vital for parents and physicians to
identify sleep problems early, so that corrective action can be taken
and obesity prevented. With childhood obesity hovering at 17 percent in
the United States, we're hopeful that efforts to address both of these
risk factors could have a tremendous public health impact."
A common cause of SDB is enlarged tonsils or adenoids, which can be
removed through surgery. Malocclusion -- misalignment of the jaws and
teeth -- which can be treated with a night guard or through orthodontic
care is being investigated as a source of SDB as well. As for lack of
sufficient sleep, which affects an estimated 25 to 50 percent of
preschoolers, "Learning good sleep habits and proper sleep hygiene can
promote healthy sleep and longer sleep duration," said Dr. Bonuck.
No comments:
Post a Comment