Sleep Duration and Risk of Obesity by Sex: Nine-Year Follow-Up of the Young Lives Study in Peru

Abstract

Background: We aimed to evaluate if there is association between hours of sleep and the risk of obesity among children and whether this association differs by sex. Methods: A secondary data analysis, using information of the Young Lives study, was conducted. The outcome was obesity, based on the BMI for age z-score; the exposure was child's sleep duration (reported by parents) categorized using the National Sleep Foundation guidelines, and as a numerical variable. Baseline and three follow-ups information were used to evaluate association, reporting relative risks (RRs), and 95% confidence intervals (CIs), as well as coefficients and 95% CI. Results: Data from 1949 children, baseline mean age 4.3 (standard deviation: 0.3) and 962 (49.5%) females, were analyzed. Short sleep duration was present in 26.0% (95% CI: 24.0-28.0) at baseline. After 9.6 years of follow-up, the incidence of obesity was 0.83 (95% CI: 0.70-0.98) per 100 person-years at risk. In multivariable model (n = 1579), there was no association between short sleep duration and obesity in the whole sample (p = 0.13); but the risk of obesity was lower among girls (n = 816; RR = 0.45; 95% CI: 0.21-0.96; p = 0.03) compared with boys (n = 763; RR = 1.43; 95% CI: 0.95-2.14; p = 0.09). On the contrary, each additional hour of sleep was associated with an increase of boy's BMI mean (0.05; 95% CI: 0.02-0.08; p < 0.001), but not among girls (-0.02; 95% CI:-0.05 to 0.01; p = 0.11). Conclusions: Our results evidenced a lower risk of obesity due to short sleep duration in girls, but not in boys. Each additional hour of sleep was associated with an increase of BMI in boys, but not in girls. Strategies are needed to guarantee adequate sleep duration in Peruvian children.

Associations between sleep duration, sleep quality, and weight status in Chinese children and adolescents

“…The association between sleep duration, sleep quality, and overweight/obesity was analyzed (Table 3 ). The group of samples with long sleep duration was not included in regression model because of small sample size ( n = 14) and low prevalence of long sleep duration (0.69%) and thus could not provide sufficient statistical power [ 47 , 48 ]. Univariate associations between sleep duration, sleep quality, and overweight/obesity of all participants were initially analyzed in Model 1.…”

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“…Finally, as noted previously, there is evidence of an association between long sleep duration and increased risk of obesity. 56 This association is likely multifactorial, and may be impacted by confounders such as depressive symptoms, sleep fragmentation, photoperiodic abnormalities, chronic fatigue, and/or an underlying disease process such as obstructive sleep apnea (OSA) or cardiovascular disease. 80…”

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“…According to the data of the World Health Organization, it is predicted that in 2030, approximately 60% of the world’s population will be affected by and 1.1 billion people will be obese[ 6 ]. It has been reported that the prevalence of obesity in Turkey has increased in parallel with that in other European countries and has reached high rates of 37% of overweight individuals and 36% of obese individuals[ 1 ]. Obesity causes more than 700 billion dollars of health expenditure globally every year.…”