Sleep-Disordered Breathing, Lack of Sleep Increase Chance of Child Obesity

child sleepingSuffering from breathing problems due to sleep disorders or from chronic lack of sleep may double the risk of developing childhood obesity up to the age of 15 years old, as revealed by a study conducted at the Albert Einstein College of Medicine at Yeshiva University. The research, published The Journal of Pediatrics, analyzed children over the course of 15 years, was able to demonstrate a correlation between breathing problems, sleep disorders, and chronic lack of sleep, while also noting that sleep disturbances can be treated.

The research team responsible for the paper entitled “Sleep-Disordered Breathing, Sleep Duration, and Childhood Overweight: A Longitudinal Study” analyzed the data of 1,899 children collected through the Avon Longitudinal Study of Parents and Children (ALSPAC). ALSPAC, which is based in Avon, England, gathers data from questionnaires filled out by parents regarding their children’s sleep duration, as well as sleep-disordered breathing (SDB) symptoms from birth to 6.75 years, and child BMI data from research ALSPAC clinics.

“In recent years, lack of sleep has become a well-recognized risk for childhood obesity,” explained the lead author of the paper, Karen Bonuck, Ph.D., who is a professor of family and social medicine as well as obstetrics & gynecology at Einstein. “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.”

Bonuck and her colleagues determined that children who suffered from the most severe symptoms of SDB also register the highest risk of obesity, being twice as likely to be obese by the ages of 7, 10, or 15 years old when compared to children who were in an asymptomatic study group. The first group of children, known as the “worst case” group, registered the highest levels of SDB symptoms such as snoring, sleep apnea or mouth-breathing.

There was also a group of children who developed symptoms between five and six years of age, but this group was less likely to develop obesity. In conclusion, the researchers demonstrated that from the participants in the study, one-fourth registered in high statistical risk of obesity due to SDB symptoms in earlier life.

Regarding the duration of sleep, the researchers concluded that the group of children who sleep fewer hours — 10.5 hours per night or less between the ages of five and six years old — had a 60 to 100 percent increased risk of being obese. On the other hand, children with short sleep duration did not register alterations in obesity risk at other ages.

Even though the study suggested that both SDB and lack of sleep are equal obesity risk triggers, the researchers demonstrated that the effects of each of the conditions is independent, and that the development of one condition is not related to the other. The investigators also emphasized that their analysis did not include variations related to the fact that there are children who are affected by both SDB and short sleep duration.

“We know that the road to obesity often begins early in life,” explained 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.”

In addition, Bonuck noted that SDB is often caused by enlarged tonsils or adenoids, problems that can be surgically removed. Another possible cause that is currently being investigated as a trigger of SDB is malocclusion, which is the misalignment of the jaws and teeth, and can be corrected with a night guard or orthodontic care. “Learning good sleep habits and proper sleep hygiene can promote healthy sleep and longer sleep duration,” added Bonuck about the short sleeping duration that affects an estimated 25 to 50 percent of preschoolers.

The study, which was funded by the National Institutes of Health and the U.K. Medical Research Council, was authored by Ronald Chervin, M.D., M.S., at University of Michigan, and Laura Howe, Ph.D., at the University of Bristol, in addition to Karen Bonuck.

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