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Pediatrics. 2018 Jul;142(1). pii: e20174085. doi: 10.1542/peds.2017-4085. Epub 2018 Jun 15.

Objective Sleep Characteristics and Cardiometabolic Health in Young Adolescents.

Author information

1
Division of Research, Kaiser Permanente Northern California, Oakland, California; elizabeth.m.cespedes@kp.org.
2
Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center.
3
Department of Neonatology, University of Tübingen, Tübingen, Germany; and.
4
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, and.
5
Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
6
Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts.

Abstract

: media-1vid110.1542/5778442247001PEDS-VA_2017-4085Video Abstract BACKGROUND AND OBJECTIVES: Shorter sleep duration is associated with childhood obesity. Few studies measure sleep quantity and quality objectively or examine cardiometabolic biomarkers other than obesity.

METHODS:

This cross-sectional study of 829 adolescents derived sleep duration, efficiency and moderate-to-vigorous physical activity from >5 days of wrist actigraphy recording for >10 hours/day. The main outcome was a metabolic risk score (mean of 5 sex-specific z-scores for waist circumference, systolic blood pressure, high-density lipoprotein cholesterol scaled inversely, and log-transformed triglycerides and homeostatic model assessment of insulin resistance), for which higher scores indicate greater metabolic risk. Secondary outcomes included score components and dual-energy radiograph absorptiometry fat mass. We measured socioeconomic status, race and/or ethnicity, pubertal status, and obesity-related behaviors (television-viewing and fast food and sugar-sweetened beverage consumption) using questionnaires.

RESULTS:

The sample was 51.5% girls; mean (SD) age 13.2 (0.9) years, median (interquartile range) sleep duration was 441.1 (54.8) minutes per day and sleep efficiency was 84.0% (6.3). Longer sleep duration was associated with lower metabolic risk scores (-0.11 points; 95% CI: -0.19 to -0.02, per interquartile range). Associations with sleep efficiency were similar and persisted after adjustment for BMI z score and physical activity, television-viewing, and diet quality. Longer sleep duration and greater sleep efficiency were also favorably associated with waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, and fat mass.

CONCLUSIONS:

Longer sleep duration and higher sleep efficiency were associated with a more favorable cardiometabolic profile in early adolescence, independent of other obesity-related behaviors. These results support the need to assess the role of sleep quantity and quality interventions as strategies for improving cardiovascular risk profiles of adolescents.

PMID:
29907703
PMCID:
PMC6260972
DOI:
10.1542/peds.2017-4085
[Indexed for MEDLINE]
Free PMC Article

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