Reduced Slow Wave Sleep Is Associated with Increased Risk of Short Stature in Children: A Cross-Sectional Study

Although growth hormone was shown to be specifically released during slow wave sleep (SWS), no population-based evidence has demonstrated the association between sleep quality and childhood height. To address this gap, our study aims to investigate the relationship between SWS and height of children.

We analyzed polysomnography data and z-scores for height in 2527 suspected obstructive sleep apnea (OSA) children (537 non-OSA children and 1990 OSA children) collected over the past 16 years. Different grades of z-scores for height and SWS were classified by the quartile method, and the lowest z-scores for height quartile defined short stature as the main outcome. Logistic regression models were used to assess the relationship between SWS and short stature.

1990 OSA children and 537 non-OSA children were included in analyses. The mean value of z-score for height from high to low were 0.80, 0.34, 0.23 and -0.19 in non-OSA children, and 0.47, 0.10, 0.14 and 0.05 in OSA children. Fully adjusted logistic regression models showed that, compared to the highest SWS quartile, the lowest quartile had 4.85-fold higher odds (95% CI, 2.4-9.4) of short stature in non-OSA children and 2.15-fold higher odds (95% CI, 1.5-3.0) in OSA children. Subgroup analyses demonstrated that in both non-OSA and OSA children, the reduction of SWS was significantly related to short stature in prepubertal children. Linear regression models confirmed positive correlations between SWS and z-score for height.

Our findings emphasize the crucial role of adequate sleep quality in childhood growth and development, supporting the inclusion of sleep assessments and improvements in pediatric growth monitoring programs.