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Sleep onset, duration, or regularity: which matters most for child adiposity outcomes?

International Journal of Obesity volume 46, pages 1502–1509 (2022)Cite this article

Subjects

Abstract

Background/Objectives

Sleep measures, such as duration and onset timing, are associated with adiposity outcomes among children. Recent research among adults has considered variability in sleep and wake onset times, with the Sleep Regularity Index (SRI) as a comprehensive metric to measure shifts in sleep and wake onset times between days. However, little research has examined regularity and adiposity outcomes among children. This study examined the associations of three sleep measures (i.e., sleep duration, sleep onset time, and SRI) with three measures of adiposity (i.e., body mass index [BMI], waist circumference, and waist-to-height ratio [WHtR]) in a pediatric sample.

Subjects/Methods

Children (ages 4–13 years) who were part of the U.S. Newborn Epigenetic STudy (NEST) participated. Children (N = 144) wore an ActiGraph for 1 week. Sleep measures were estimated from actigraphy data. Weight, height, and waist circumference were measured by trained researchers. BMI and WHtR was calculated with the objectively measured waist and height values. Multiple linear regression models examined associations between child sleep and adiposity outcomes, controlling for race/ethnicity, child sex, age, mothers’ BMI and sleep duration.

Results

When considering sleep onset timing and duration, along with demographic covariates, sleep onset timing was not significantly associated with any of the three adiposity measures, but a longer duration was significantly associated with a lower BMI Z-score (β = −0.29, p < 0.001), waist circumference (β = −0.31, p < 0.001), and WHtR (β = −0.38, p < 0.001). When considering SRI and duration, duration remained significantly associated with the adiposity measures. The SRI and adiposity associations were in the expected direction, but were non-significant, except the SRI and WHtR association (β = −0.16, p = 0.077) was marginally non-significant.

Conclusions

Sleep duration was consistently associated with adiposity measures in children 4–13 years of age. Pediatric sleep interventions should focus first on elongating nighttime sleep duration, and examine if this improves child adiposity outcomes.

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Fig. 1: Flow diagram describing the cohort for analyses.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This research was supported by the National Institute of Environmental Health Sciences (R01ES016772, P30ES011961 pilot project, R21ES014947, P01ES022831, and R24ES028531), the US Environmental Protection Agency (RD-83543701), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD084487), the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK085173), and the Duke Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. Further, USEPA does not endorse the purchase of any commercial products or services mentioned in the publication. In addition, this research was supported in part by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences. This work was also supported, in part, by the National Cancer Institute (T32CA093423) for ELA postdoctoral effort and by the National Institute of General Medical Sciences (2K12GM093857-10) for TEG postdoctoral effort.

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Authors and Affiliations

  1. Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA

    Trevin E. Glasgow, D. Jeremy Barsell & Bernard F. Fuemmeler

  2. Department of Exercise Science, University of South Carolina, Columbia, SC, USA

    Elizabeth L. Adams

  3. RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic

    Albert Ksinan

  4. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA

    Jessica Lunsford-Avery & Julia C. Schechter

  5. Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA

    Shanshan Chen

  6. Holmusk, Durham, NC, USA

    Scott Kollins

  7. Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA

    Rachel Maguire

  8. Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Rachel Maguire

  9. Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA

    Matthew Engelhard

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Contributions

TEG, ELA, AK, DJB, JLA, SC, SK, JCS and BFF contributed to the conceptualization of the study. JCS, RM and BFF supervised data collection. TEG, SC, AK and ME analyzed the data. All authors contributed to writing and editing of the paper.

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Correspondence to Bernard F. Fuemmeler.

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Glasgow, T.E., Adams, E.L., Ksinan, A. et al. Sleep onset, duration, or regularity: which matters most for child adiposity outcomes?. Int J Obes 46, 1502–1509 (2022). https://doi.org/10.1038/s41366-022-01140-0

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