Sleep and Adiposity Outcomes in School-Age Children with Overweight and Obesity

Purpose: To examine four dimensions of sleep (timing, quality, quantity, and variability) and their association with adiposity outcomes in a community sample of school-age children with overweight and obesity. Design: A cross-sectional actigraphic study. Methods: 246 school-age children aged 6-9 years with overweight or obesity were recruited from 10 public elementary schools in Taipei, Taiwan. Children's sleep was objectively assessed over a 7-day period using a wrist actigraph. Adiposity outcomes, including BMI, BMI-for-age z-score, and percent body fat, were computed based on measured weight, height, and skinfold thickness following standardized procedures. Associations between sleep and child adiposity outcomes were examined using bivariate and multiple linear regression analyses. Results: In the bivariate analyses, later sleep onset time was correlated with greater percent body fat (p = .01); shorter daily sleep duration was correlated with higher BMI and percent body fat (both p < .05); greater variability in daily sleep duration was correlated with higher BMI, BMI-for-age z-score, and percent body fat (all p < .05). In multiple linear regression analyses, variability in daily sleep duration was the only sleep characteristic that showed a statistically significant association with percent body fat in children (b = 2.36; 95% CI: 0.28 to 4.43; p = .02). Conclusions: Overweight and obesity treatment interventions targeting child weight management should prioritize the assessment and promotion of children's sleep regularity. Future randomized controlled trials are needed to investigate the impact of maintaining a more consistent sleep pattern on measures of adiposity in school-age children with overweight and obesity.