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Medical News: More ZZZs Linked to Healthier Kids - Printable Version http://www.medpagetoday.com/tbprint.cfm?

tbid=24486

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More ZZZs Linked to Healthier Kids
By Crystal Phend, Senior Staff Writer, MedPage Today
January 24, 2011

MedPage Today Action Points

More sleep, even if only "catch-up" on weekends, could help protect


school-age kids against obesity and other metabolic problems, an
observational study suggested.

Note that short nights and variable sleep patterns were also associated with
altered levels of insulin, LDL cholesterol, and the inflammatory marker
high-sensitivity C-reactive protein among a subsample of the study group.

Review
Children who get more sleep, even if it's only "catch-up" sleep on weekends, may be
protected against obesity and other metabolic problems, researchers suggested.

A study conducted among more than 300 children ages four to 10, found that those
who slept the least and had the most irregular sleep schedules were over 4.4-fold
more likely to be obese, David Gozal, MD, of the University of Chicago, and
colleagues found.

Short nights and variable sleep patterns were also linked to altered levels of insulin,
LDL cholesterol, and the inflammatory marker high-sensitivity C-reactive protein
among a subsample of the study group, Gozal and co-authors reported online in
Pediatrics.

But compensating with extra sleep on the weekends lowered the kids' risk of obesity
to less than 2.2-fold excess, the group wrote.

Even just an extra half hour of sleep per night might lower body mass index (BMI)
and reduce the metabolic effects that predispose to diabetes and cardiovascular
disease later in life, they proposed.

Not getting enough sleep could cause changes in neuropeptides that regulate
appetite -- raising ghrelin and reducing leptin -- and lead to more eating and obesity,
Gozal's group explained.

There are plenty of other good reasons not to shortchange kids on sleep, Gozal
added in an interview.

"If you want your child to be happy and to succeed, prioritize sleep," he told

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Medical News: More ZZZs Linked to Healthier Kids - Printable Version http://www.medpagetoday.com/tbprint.cfm?tbid=24486

MedPage Today.

"Optimal sleep is associated with better attention, better ability to learn, and better
memory," he explained. "There are a lot of advantages about sticking to a regular
bedtime routine with appropriate time being allowed for the child to sleep."

Although the observational study couldn't draw causal links between sleep and
weight or metabolism -- or show a benefit from increasing sleep in kids who initially
didn't get enough -- there's plenty of evidence from prior research to suggest that
both are the case, according to Gozal.

The researchers monitored the sleep patterns among 308 healthy children ages 4 to
10 using wrist actigraphs over a one week period. The kids, recruited from public
schools in Louisville, Ky., were considered representative of the general school
population.

The kids averaged about eight hours of sleep per night overall, regardless of weight
or school week versus weekend -- an amount substantially below the recommended
nine to 10 hours of sleep per night, Gozal noted.

But the kids' patterns of sleep differed by weight class.

Obese children slept less and less as the week progressed -- reaching a significant
low on the weekends (P=0.03).

Overweight kids tended to do the opposite, increasing their sleep as the week
progressed, but the variability from weekdays to weekends was relatively stable
without a significant difference for them or normal weight children (P=0.49 and
P=0.20, respectively).

A random sample of about one-third of the children measured for metabolic markers
after an overnight fast showed no overall metabolic interactions between sleep
patterns and BMI z scores.

But consistently long sleep in the recommended range of about 9.5 hours on both
weekdays and weekends was associated with the healthiest metabolic profile.

Significant alterations in insulin, LDL, and high-sensitivity C-reactive protein levels


were linked to short sleep duration (about 6.5 hours) throughout the week as well as
normal duration (about eight hours) on the weekend whether long or short on school
nights.

"In other words, the longer and more-stable sleep duration is, the less likely a child
is to manifest metabolic dysfunction," the researchers concluded in the paper.

Gozal and colleagues cautioned that the study only measured sleep over one week
representing a typical school week and longer studies that include holidays and
vacations might be more accurate in predicting associations.

Other limitations were lack of measurements of body fat distribution and the
predominantly non-Hispanic white make-up of the Louisville school-age population --
which may limit generalizability of the results to more diverse areas, they noted.

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Medical News: More ZZZs Linked to Healthier Kids - Printable Version http://www.medpagetoday.com/tbprint.cfm?tbid=24486

The study was funded by the National Institutes of Health. The researchers reported having no conflicts of
interest to disclose.

Primary source: Pediatrics


Source reference:
Spruyt K, et al "Sleep duration, sleep regularity, body weight, and metabolic
homeostasis in school-aged children" Pediatrics 2011; 127: e345–e352.

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