The relationship of sleep duration and quality to energy expenditure and physical activity in children

Authors: JINDAL, ISHITA - Children'S Nutrition Research Center (CNRC); PUYAU, MAURICE - Children'S Nutrition Research Center (CNRC); ADOLPH, ANNE - Children'S Nutrition Research Center (CNRC); BUTTE, NANCY - Children'S Nutrition Research Center (CNRC); MUSAAD, SALMA - Children'S Nutrition Research Center (CNRC); BACHA, FIDA - Children'S Nutrition Research Center (CNRC)

Submitted to: Pediatric Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/20/2020
Publication Date: 11/15/2020
Citation: Jindal, I., Puyau, M., Adolph, A., Butte, N., Musaad, S., Bacha, F. 2020. The relationship of sleep duration and quality to energy expenditure and physical activity in children. Pediatric Obesity. e12751. https://doi.org/10.1111/ijpo.12751.
DOI: https://doi.org/10.1111/ijpo.12751

Interpretive Summary: Multiple studies found an association between short sleep duration and obesity in children and adolescents. However, the mechanisms underlying the relationship between sleep and the risk for obesity in children are unclear. One mechanism may be through changes in energy metabolism and physical activity. In this study, we investigated the relationship of various sleep parameters (sleep duration and quality) during school break (seven consecutive non-school days) in children, to energy metabolism and physical activity. We studied 59 children in two age groups (5-11 and 12-18 years). We measured their body composition, basal metabolic rate (BMR) which is a major determinant of energy needs in a room calorimeter, free-living energy expenditure (how much energy they use) by doubly labeled water method, and sleep and physical activity parameters (7-day accelerometer monitor) during school break. We found that children and adolescents do not consistently meet age-recommended sleep duration during school break. Late sleep timing emerged as an important factor in determining physical activity in children. In younger children particularly, reduced sleep duration was related to increased sedentary behavior and less time spent in light physical activity. In addition, shorter sleep duration was associated with lower basal metabolic rate after accounting for age, sex, fat mass and lean mass. This indicates that insufficient sleep duration and late sleep timing may lead to increased weight gain over time by interfering with physical activity and energy metabolism. Our data support the importance of sleep hygiene with appropriate timing and adequate duration in promoting an active lifestyle and minimizing sedentary behaviors to prevent childhood obesity.

Technical Abstract: Shorter sleep duration has been linked to the risk for obesity in children. The pathways linking sleep duration and quality to the risk of obesity are unclear, particularly the effect of sleep on energetics. We investigated the relationship between sleep duration, quality and timing in children, to the basal metabolic rate (BMR), total energy expenditure (TEE) and physical activity (PA). Fifty nine children in two age-groups (5-11 and 12-18 years) underwent evaluation of body composition (DXA), BMR in a room calorimeter, free-living TEE by doubly labelled water method, sleep and PA (7-day Actiheart monitor) during school break. Sleep duration contributed to the variance in BMR (B = 0.11, P = .009) after adjusting for age-group, sex, lean and fat mass, but not to the variance in TEE. Late sleep timing was related to lower PA. In the younger age-group, children who met recommended sleep duration on >/-50% of the 7 days had higher light PA (P = .03) and lower sedentary time (P = .009). Suboptimal sleep is associated with lower BMR, lower PA, and higher sedentary behaviours in young children. Prospective studies are needed to confirm if insufficient sleep duration or late sleep timing contribute to obesity risk by increasing sedentary behaviours and decreasing BMR.