Severe paediatric obesity and sleep: A mutual interactive relationship!

Abstract

Achieving and maintaining a healthy weight requires adequate sleep (Sekine et al., 2002;Taheri, 2006). Adequate sleep is a strong weapon for good health in general. Childhood and adolescent severe obesity are associated with serious co-morbidities, including obstructive sleep-disordered breathing (SDB), sleep disturbances, daytime sleepiness, asthma, type 2 diabetes mellitus, hypertension, dyslipidaemia, non-alcoholic fatty liver disease (NAFLD), and even premature death (Kelly et al., 2013). Children growing up in poverty have lower sleep quality and duration, which may lead to childhood obesity (Bagley, Kelly, Buckhalt, & El-Sheikh, 2015). Furthermore, adolescents are at higher risk of insufficient sleep due to a physiological delay in sleep phase plus academic and social demands (Gohil & Hannon, 2018). These childhood problems can complicate adulthood, as severe childhood obesity is associated with adulthood obesity. Additionally, the co-morbidities of severe obesity can have lasting sequelae, such as cardiovascular, metabolic and neurocognitive morbidities (Lo Bue, Salvaggio, & Insalaco, 2020) .Severe obesity was previously defined as body mass index (BMI) > 99th percentile, but more recently it has been defined as BMI ≥ 120% of the 95th percentile as class II and BMI ≥ 140% of the 95th percentile as class III obesity (Skinner, Ravanbakht, Skelton, Perrin, & Armstrong, 2018). Skinner et al. (2018) studied the prevalence of obesity and severe obesity in US children from 1999 to 2016, and reported a significant increase in severe obesity among children aged 2−5 years since the 2013-2014 cycle, a trend that continued upward for many years.

Childhood sleep: physical, cognitive, and behavioral consequences and implications

“…Furthermore, both insufficient and excessive sleep were linked to short-term and long-term hyperglycemia in obese adolescents [ 34 ]. More current research reports that daytime sleepiness [ 35 ], midday napping [ 33 ], poor sleep quality [ 36 ], weekday–weekend sleep variability [ 37 ], greater sleep disturbances (e.g., night awakenings or overall disturbance score) [ 38 ], and a delayed sleep phase pattern [ 29 ] are also associated with obesity. However, the directionality of the relationship between sleep and obesity is unclear, as literature also reports that obese children are more likely to sleep for shorter durations and have more length variability between the weekdays and weekends compared with children classified as overweight, normal, or underweight [ 37 ].…”

Sleep Quality and Duration in European Adolescents (The AdolesHealth Study): A Cross-Sectional, Quantitative Study

“…When comparing cities, a significantly higher PSQI index was obtained by participants from Seville in comparison to those from Reykjavik. These scores could be justified by recent studies, in which the subjects from Seville had a higher % of body fat compared to those from Reykjavik [58,69], which could affect their sleep quality [73,86,87]. Furthermore, the different meal times (especially in regards to dinner) characteristic of the Mediterranean population (<3 h before sleeping) could contribute to poor sleep quality due to gastrointestinal upset, heartburn and reflux [35].…”

Sleep Disordered Breathing: An Epidemiological Study among Albanian Children and Adolescents

“…The pediatric individuals with sleep disorders present hyperactivity, restlessness, lack of attention, loss of appetite and irritability [3,4]. If left untreated, SDB in development age could be responsible to significant morbidity leading to metabolic syndrome [5], cardiovascular consequences [6], and growth failure [7]. The negative impact of SDB may not simply be confined to the short-term wellness and development during childhood but may continue adversely affecting during the long-term development in adulthood.…”