Sleep Disordered Breathing in Children increases Obesity Risk

Sleep-disordered breathing is a group of respiratory disorders. The most common one is obstructive sleep apnea. Mixed sleep apnea and central sleep apnea also are included.

According to new research from Albert Einstein College of Medicine of Yeshiva University, sleep-related breathing problems and chronic lack of sleep may double the risk of a child becoming obese by age 15.

There is good news, however: both sleep problems can be cured.

“In recent years, lack of sleep has become a well-recognized risk for childhood obesity,” said lead author Karen Bonuck, Ph.D. “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.”

Dr. Bonucks team used data from the Avon Longitudinal Study of Parents and Children. The Avon study collected information on 1,899 children from parent questionnaires. Both child sleep duration and sleep disordered breathing symptoms were investigated. The data came from children from birth through 6.75 years and child BMI data.

Sleep Disordered Breathing in Children Doubles Obesity Risk

The researchers observed that children with the most severe SDB had the highest risk for obesity.

Children who fell into the worst case category of SDB were twice as likely to become obese by 7, 10 and 15 years of age, compared with the non-symptomatic group. Children considered worst case were those who scored highest on SDB symptoms of snoring, sleep apnea or mouth-breathing.

Children whose SDB peaked at a later age, about 5 to 6 years old, did better but still had a 60 to 80 percent increased risk of becoming obese.

On the whole, 25 percent of children in this group had an increased statistical risk of obesity. The risk arose from SDB symptoms experienced earlier in life. Obesity was defined as BMI greater than the 95th percentile for age and gender.

Early Diagnosis is Key

“We know that the road to obesity often begins early in life,” said Dr. Bonuck. “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 percent in the United States, we’re hopeful that efforts to address both of these risk factors could have a tremendous public health impact.”

One widespread cause of sleep disordered breathing is enlarged tonsils or adenoids. These can be removed through surgery. Malocclusion, or misalignment of the jaws and teeth,  is being investigated as a source of SDB as well. Malocclusion can be easily treated with a night guard or through orthodontic care

In terms of lack of sufficient sleep, affecting an estimated 25 to 50 percent of preschoolers what can be done?

“Learning good sleep habits and proper sleep hygiene can promote healthy sleep and longer sleep duration,” said Dr. Bonuck.

SDB and lack of sleep were found to be equally strong risk factors for obesity. However, their effects were independent of each other.

Researchers investigated links between short-sleep-duration children and sleep disordered breathing children. Children  across all age groups included in the study showed no sign of clustering. In other words, there was scant evidence that children with one risk factor were more likely to also be affected by the other.

The study did not analyze whether children affected by both of the sleep-related risk factors were at greater risk for obesity than were children who had just one risk factor.

For More Information:

Karen Bonuck, Ronald D. Chervin, Laura D. Howe
Sleep-Disordered Breathing, Sleep Duration, and Childhood Overweight: A Longitudinal Cohort Study
The Journal of Pediatrics Published online: December 10, 2014 DOI: http://dx.doi.org/10.1016/j.jpeds.2014.11.001

Spruyt, K. and Gozal, D.
The underlying interactome of childhood obesity: the potential role of sleep.
Child Obes . 2012; 8: 38–42

Photo: Connor Ashleigh for AusAID.