A child’s risk of becoming obese by age 15 years may be increased by sleep-related breathing problems and chronic lack of sleep, according to recent study findings published in The Journal of Pediatrics.

“In recent years, lack of sleep has become a well-recognized risk for childhood obesity,” Karen Bonuck, PhD, of Albert Einstein College of Medicine in Bronx, N.Y., said in a press release. “Sleep-disordered breathing, or SDB, which includes snoring and sleep apnea, is also a risk factor for obesity but receives less attention. These two risk factors had not been tracked together in children over time to determine their potential for independently influencing weight gain. Our study aimed to fill in that gap.”

Karen Bonuck

Bonuck and colleagues evaluated 1,899 children from birth to age 6.75 years to determine the effects of sleep duration and SDB on childhood BMI.

Participants were divided into five SDB clusters including: no symptoms (asymptomatic; 45%); peak at 6 months (symptoms peak at 6 months, then abate; 18.5%), peak at 18 months (symptoms peak at 18 months, then abate; 10.5%), worst case (symptoms rise at 18 months, peak at 30 to 40 months and remain high; 7%) and late symptom (modest symptoms appear at 42 months and remain high; 19%). Associations were examined for each SDB cluster and sleep duration at age 18 months, 2.5 years, 5.75 years and 6.75 years.

Compared with the asymptomatic group, the worst case group were twice as likely to become obese by age 7, 10 and 15 years. Snoring, sleep apnea and mouth-breathing were the most common SDB symptoms among the worst case group.

Participants in the late symptom group demonstrated an 80% increased risk for obesity at age 7 years and a 60% increased risk at age 15 years.

There was a significant association with obesity at age 15 years and short sleep duration at age 4.75 and 5.75 years. There was a 55% to 65% increased risk for obesity at age 15 years with short sleep duration at 5.75 years. Obesity at age 15 years was less likely among participants with the longest sleep duration at age 2.5 years (OR=0.5; 95% CI, 0.26-0.97).

“We know that the road to obesity often begins early in life,” Bonuck said. “Our research strengthens the case that insufficient sleep and SDB — especially when present early in childhood — increase the risk for becoming obese later in childhood. If impaired sleep in childhood is conclusively shown to cause future obesity, it may be vital for parents and physicians to identify sleep problems early, so that corrective action can be taken and obesity prevented. With childhood obesity hovering at 17% in the United States, we’re hopeful that efforts to address both of these risk factors could have a tremendous public health impact.”