Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Pediatr Obes. 2021 Jul;16(7):e12766. doi: 10.1111/ijpo.12766. Epub 2020 Dec 28.
The respective contribution of total, daytime and nighttime sleep duration in childhood obesity remains unclear.
To assess the longitudinal association between developmental trajectories of sleep duration and BMI z-score in early childhood.
Data were from the Melbourne INFANT program, a prospective cohort with 4-month-old infants being followed-up until age 60 months (n = 528). Sleep duration (total, daytime, nighttime) and BMI z-score were measured using questionnaire at ages 4, 9, 18, 43 and 60 months. Group-based trajectory modelling was used to describe longitudinal trajectories from ages 4 to 60 months. Multivariable logistic regression was conducted to assess the association between sleep duration and BMI z-score trajectories.
Three nighttime sleep duration trajectory groups were identified: "Long stable" (10.5 to 11.0 hours, 61%), "catchup long" (8.0 to 11.5 hours, 23%) and "short stable" (8.7 to 9.8 hours, 16%) nighttime sleepers. BMI z-score trajectory groups were classified as "low-BMIz" (-1.5 to -0.5 unit, 21%), "mid-BMIz" (-0.5 to 0.5 unit, 58%) and "high-BMIz" (0.8 to 1.4 unit, 21%). With adjustment for child and maternal covariates, both "catchup long" (OR 3.69 95%CI 1.74, 7.92) and "long stable" nighttime sleepers (OR 4.27 95%CI 2.21, 8.25) revealed higher odds of being in the "mid-BMIz" than the "high-BMIz" group. By contrast, total or daytime sleep duration trajectories were not associated with BMI z-score trajectories.
Longer nighttime, but not total or daytime, sleep duration was associated with lower BMI z-score trajectories in early childhood. Our findings reinforce the importance of nighttime sleep for healthy body-weight development in early childhood.
儿童肥胖中总睡眠时间、白天睡眠时间和夜间睡眠时间的各自贡献仍不清楚。
评估儿童早期睡眠时间发展轨迹与 BMI z 评分之间的纵向关联。
数据来自墨尔本婴儿研究计划,这是一项前瞻性队列研究,对 4 个月大的婴儿进行随访,直至 60 个月(n=528)。在 4、9、18、43 和 60 个月时,使用问卷测量睡眠时间(总睡眠时间、白天睡眠时间、夜间睡眠时间)和 BMI z 评分。使用基于群组的轨迹建模来描述从 4 岁到 60 岁的纵向轨迹。进行多变量逻辑回归以评估睡眠时间与 BMI z 评分轨迹之间的关联。
确定了三种夜间睡眠时间轨迹组:“长时间稳定”(10.5 至 11.0 小时,61%)、“追赶式长时间”(8.0 至 11.5 小时,23%)和“短时间稳定”(8.7 至 9.8 小时,16%)夜间睡眠者。BMI z 评分轨迹组分为“低 BMIz”(-1.5 至-0.5 单位,21%)、“中 BMIz”(-0.5 至 0.5 单位,58%)和“高 BMIz”(0.8 至 1.4 单位,21%)。调整儿童和产妇协变量后,“追赶式长时间”(OR 3.69,95%CI 1.74,7.92)和“长时间稳定”夜间睡眠者(OR 4.27,95%CI 2.21,8.25)的夜间睡眠时间均显示出较高的几率处于“中 BMIz”组而非“高 BMIz”组。相比之下,总睡眠时间或白天睡眠时间轨迹与 BMI z 评分轨迹无关。
较长的夜间睡眠时间,而非总睡眠时间或白天睡眠时间,与儿童早期较低的 BMI z 评分轨迹相关。我们的研究结果强调了夜间睡眠对儿童早期健康体重发育的重要性。