Study Ties Children’s Sleep Quality To Obesity Rates

A new study published in the journal Pediatrics suggests that infants and young children who regularly get insufficient sleep may face a greater risk of obesity by age 7.

Researchers from Massachusetts General Hospital for Children analyzed data from 1,046 children and gathered information from the children's mothers at 6 months, 3 years and 7 years. They also compiled information from questionnaires completed by the children when they were ages 1, 2, 4, 5 and 6.
The interviews with the mothers included questions about their children's sleep duration at night and during nap time.

When the children were age 7, the researchers gathered information on their height and weight, as well as their lean body mass, waist and hip circumference, total body fat and abdominal fat. The researchers then assigned sleep scores to the children based on their levels of sleep throughout the entire study period, with 0 being the highest levels of insufficient sleep and 13 being the lowest levels of insufficient sleep (no reports of insufficient sleep).
The average sleep score among the children was 10.2; more than half of children in the study did not experience much sleep curtailment over the study period. A little more than 4 percent of the children received a score of 0 to 4, 12.3 percent received a score of 5 to 7, and 14.1 percent scored 8 to 9. However, 28.8 percent received a score of 10 to 11, and 40.3 percent received a score of 12 to 13.

Researchers found an association between sleep curtailment and obesity, with sleep curtailment at all ages being associated with higher levels of measurements indicative of obesity. Kids who received the lowest sleep scores had higher total and trunk fat mass index, as well as higher waist and hip circumferences, compared with kids who received the highest sleep scores. There was also an association between lower sleep scores and socioeconomic factors, such as household income and maternal education. However, even after adjusting for these factors, researchers still found the association between sleep curtailment and obesity.

While this is hardly the first study to show an association between inadequate sleep and obesity, this study is unique in that it looked at sleep curtailment over time. Another recent study in the journal Childhood Obesity showed that one of the three most significant obesity risk factors for preschoolers is insufficient sleep (the other two are having a parent who is overweight or obese, and having parents who restrict the preschooler's eating because of weight control). The Society of Behavioral Medicine has also released a study which showed that sleep seemed to be associated with weight especially among low-income kids, with normal-weight children sleeping about a half hour more than overweight or obese children.

The study can't tell whether the missed sleep actually caused the kids to put on fat; it's possible that some factor the authors didn't account for was the real culprit. But there are several theories that might tie curtailed sleep to obesity, including the ebb and flow of hormones that control hunger.
Much of the research on mechanisms depends on findings in adults, and additional factors may be at play in kids, according to a lead author of the study. For example, a poor sleep routine at home also means that eating and meal patterns are probably also disrupted in those homes.

Dr. Jerald Simmons is active in treating pediatric sleep disorders and has long stressed the importance of proper sleep habits and patterns for kids. Childhood sleep disorders have also been linked to ADD and ADHD. For more information visit our website at HoustonSleep.net.

Sleep disorders may cause ADD/ADHD

For more than three decades, there has been a growing recognition that some people have difficulty focusing and maintaining attention; in various instances, they also may have difficulty sitting peacefully in a classroom
or calm setting. These individuals have been labeled with attention deficit disorder - with or without hyperactivity -known as ADD/ADHD.

Traditional treatment for ADD/ADHD has been with stimulant medications, such as Ritalin or Adderall, which provide improvement by stimulating a fatigued, unrested brain. It is now known that problems with sleep can result in difficulties with concentration and the ability to stay focused during the day. The increased physical activity -hyperactivity - displayed by many of those affected is a way of remaining stimulated, thus overcoming the sleepiness. This difficulty is most noted when sitting inactive and under-stimulated.

About 30 percent of these patients have a sleep disturbance as a fundamental cause according to Dr. Simmons, who has treated these types of patients for over 20 years. If a sleep disorder is present, there are other treatment options for improvement of the ADD/ADHD symptoms.
"If there is a concern that a child or adult has ADD/ADHD, then it is imperative to first make a few observations regarding the person's sleep in order to determine whether a sleep disorder center consultation is necessary, prior to starting stimulant drugs," Dr. Simmons continued. "In many cases, those who have been placed on stimulants can be successfully taken off them if a sleep problem has been properly diagnosed and treated. For years now, I have taken this approach and many patients labeled with ADD/ADHD in whom we have diagnosed with a sleep disturbance have demonstrated dramatic improvement after treating the sleep disorder. This treatment has minimized or eliminated their reliance on stimulant medications."

The main causes for the disturbed sleep in the ADD/ADHD population are lack of sleep due to domestic/environmental factors in the home, restless legs syndrome or obstructive sleep apnea, or an associated condition known as the Upper Airway Resistance Syndrome.

UARS is a subtle breathing disorder not properly diagnosed at most sleep centers; but by utilizing extra measures Dr. Simmons' team is able to recognize and treat this disorder properly. "We look at a whole battery of issues when someone complains of ADD/ ADHD, including both psychological and physiological factors," Simmons said. "I've seen many patients improve when we treat their sleep without the need for stimulants."

An example of one such patient is Trey Girlinghouse, a 9-year-old whose teachers became concerned with his difficulties in school. They encouraged his mother to find medical assistance for what they labeled as ADD; he was placed on stimulant medication treatment, but his mother was concerned about medication usage and looked for alternative treatments.
She had Trey evaluated by Dr. Simmons, and after a comprehensive sleep test he was found to have UARS. He then began treatment for this breathing disorder and is no longer on stimulants: he has also markedly improved his performance at school.
"Now that his sleep is better and he does better at school, the teachers agree that he no longer needs to be on medications," his mother said.

Dr. Simmons provides this partial list of signs which should raise concerns when considering whether ADD/ADHD may be associated with a sleep disturbance:

•  Difficulty falling asleep 
• Difficulty staying asleep 
• Snoring or labored breathing 
• Kicking repetitively during the night 
• Excessively grinding or clenching teeth 
• Difficulty awakening in the morning 
• Sleep walking or sleep talking 
•  Noticeable sleepiness during the day when not active

If someone has any of these indicators and appears to suffer with ADD/ADHD symptoms, then a proper sleep evaluation would be warranted. Patients can be evaluated by contacting CSMA's sleep centers throughout Greater Houston at 281-407-6222.
Visit www.HoustonSleep.net for more information and fill out our questionnaire to initiate an evaluation.