PURPOSE: Examine associations between sleep patterns (duration, timing, and regularity) and weight status and explore moderating effects of parenting/family functioning among children with mild sleep-disordered breathing (SDB) from the Pediatric Adenotonsillectomy Trial for Snoring.
METHODS: Two age groups (3-5 and 6-12-year-olds) were examined separately with waist circumference (WCz) and body mass index (BMIz) z-scores as the primary and secondary endpoints, respectively.
RESULTS: Participants were 207 younger and 252 older children in a socio-demographically diverse sample. In adjusted models with older children, shorter sleep was associated with higher WCz, controlling for weekend mid-sleep timing (coefficient estimate beta = - 0.137, p = 0.027) with a similar finding for BMIz (beta = - 0.144, p = 0.041); later timing was related to higher WCz, controlling for sleep duration (beta = 0.122, p = 0.032). Shorter sleep duration was associated with higher WCz among the older children with greater parental distress (interaction p = 0.005), parent-child dysfunctional interactions (interaction p = 0.020), and less authoritative parenting (interaction p = 0.023) compared to those with more optimal parent-child relationships. There were no statistically significant associations or interactions among younger children.
CONCLUSIONS: In school-aged children, shorter sleep duration and later midpoint, but not social jet lag, tended to be associated with weight status. When mutually adjusting for duration and midpoint, a stronger statistically significant association was observed. Children subject to less optimal parenting practices were at the greatest risk of shorter sleep. Accounting for sleep timing and parenting factors that might further increase children's biological propensity for obesity is recommended in future studies in this area.
CURRENT KNOWLEDGE/STUDY RATIONALE: Initial evidence suggests that shorter sleep duration and sleep-disordered breathing (SDB) increase the risk of becoming overweight in later childhood. This study examined relationships of additional sleep patterns-timing and regularity-and possible moderating effects of parenting/family factors using a well-characterized cohort of children with mild SDB from the Pediatric Adenotonsillectomy Trial for Snoring.
STUDY IMPACT: This study demonstrates that both shorter sleep duration and later timing relate to higher waist circumference and body mass index z-scores among school-aged children. Parenting factors (i.e., stress, parent-child dysfunctional relationships, and less use of an authoritative parenting style) may moderate sleep pattern-weight status relationships and therefore identify children most vulnerable to obesity because of insufficient sleep.
