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Longitudinal associations of sleep curtailment with metabolic risk in mid-childhood
Elizabeth M Cespedes1, Sheryl L Rifas-Shiman, Susan Redline
1Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA; Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Insights
Chronic insufficient sleep in children is linked to higher metabolic risk. This association is primarily driven by sleep
Area of Science:
- Pediatric Health
- Cardiometabolic Health
- Sleep Science
Background:
- Childhood sleep duration is a critical factor in overall health.
- Insufficient sleep may impact cardiometabolic risk factors in children.
Purpose of the Study:
- To investigate the association between chronic insufficient sleep and cardiometabolic health in mid-childhood.
- To understand the role of sleep duration in metabolic risk development from infancy to school age.
Main Methods:
- Longitudinal cohort study (Project Viva) tracking children from 6 months to 7 years.
- Sleep duration assessed via maternal reports, creating a sleep curtailment score.
- Metabolic risk score calculated using z scores for waist circumference, blood pressure, HDL cholesterol, triglycerides, and HOMA-IR.
Main Results:
- Children with the most curtailed sleep showed a higher metabolic risk score (0.29 units, 95% CI: 0.02, 0.57).
- This association was attenuated when adjusting for mid-childhood Body Mass Index (BMI) z score.
- The influence of sleep duration on mid-childhood adiposity explained the link between insufficient sleep and metabolic risk.
Conclusions:
- Chronic insufficient sleep from infancy through school age is associated with increased mid-childhood metabolic risk.
- Mid-childhood adiposity mediates the relationship between sleep duration and metabolic risk.
- Promoting adequate sleep in children is crucial for preventing cardiometabolic disease.
Objective:
To examine associations of chronic insufficient sleep with mid-childhood cardiometabolic health.
Methods:
At 6 months and yearly from 1 to 7 years, mothers participating in the Project Viva cohort reported children's 24-h sleep duration. The main exposure was a sleep curtailment score, ranging from 0 (maximal curtailment) to 13 (never having curtailed sleep). The main outcome was a mid-childhood metabolic risk score, derived as the mean of five sex- and cohort-specific z scores for waist circumference, systolic blood pressure, HDL cholesterol (scaled inversely), and log-transformed triglycerides and HOMA-IR; higher scores indicate higher risk.
Results:
The mean (SD) sleep score was 10.0 (2.8); 5.1% scored 0-4, 13.9% scored 5-7, 14.1% scored 8-9, 28.7% scored 10-11, and 38.3% scored 12-13. Mean (SD, range) metabolic risk score was -0.03 (0.6, -1.8 to 2.6). In multivariable models, the metabolic risk score difference for children with most versus least curtailed sleep was 0.29 units (95% confidence interval [CI]: 0.02, 0.57). Further adjustment for mid-childhood BMI z score attenuated this difference to 0.08 units (95% CI: -0.14, 0.30).
Conclusions:
Chronic insufficient sleep from infancy to school-age was associated with higher mid-childhood metabolic risk. This association was explained by sleep duration's influence on mid-childhood adiposity.
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