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Sleep. 2018 Apr 1;41(4). doi: 10.1093/sleep/zsy018.

Sleep duration and incidence of obesity in infants, children, and adolescents: a systematic review and meta-analysis of prospective studies.

Author information

Division of Health Sciences (Mental Health and Wellbeing), Warwick Medical School, University of Warwick, Coventry, UK.
Epidemiology and Public Health, Wageningen University, The Netherlands.
University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.


Study Objectives:

To assess the prospective relationship between sleep and obesity in a paediatric population.


We performed a systematic search using PubMed, Embase, Web of Science, and Cochrane (up to September 25, 2017). Included studies were prospective, had follow-up of ≥1 year, had duration of sleep at baseline, and measures of incidence of overweight or obesity and/or changes in body mass index (BMI) z-score and BMI during follow-up. We extracted relative risks or changes in BMI z-score or BMI and 95% confidence intervals (CI) and pooled them using a random effect model.


Forty-two studies were included but, as there was significant heterogeneity, results are presented by age strata. Short sleep was associated with a greater risk of developing overweight or obesity in infancy (seven studies, 14738 participants, risk ratio [RR]: 1.40; 95% CI 1.19 to 1.65; p < .001), early childhood (eight studies, 31104 participants, RR: 1.57; 1.40 to 1.76; p < .001), middle childhood (three studies, 3005 participants, RR: 2.23; 2.18 to 2.27; p < .001), and adolescence (three studies, 26652 participants, RR: 1.30; 1.11 to 1.53; p < .002). Sleep duration was also associated with a significant change in BMI z-score (14 studies, 18 cohorts, 31665 participants; mean difference -0.03; -0.04 to -0.01 per hour sleep; p = .001) and in BMI (16 studies, 24 cohorts, 24894 participants; mean difference -0.03 kg/m2; -0.04 to -0.01 for every hour of increase in sleep; p = .001).


Short sleep duration is a risk factor or marker of the development of obesity in infants, children, and adolescents.


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