In the Journals

Sleep duration, quality affect CV health among adolescents

Longer sleep duration and higher sleep efficiency were linked to a favorable cardiometabolic profile in early adolescence, independent of other obesity-related behaviors, researchers reported.

According to the study published in Pediatrics, duration and the percentage of sleep that is undisturbed in young adolescents have a significant effect on CV health factors such as BP, cholesterol levels and abdominal fat deposition.

“While many studies have associated shorter sleep duration with increased obesity levels in children, few have examined effects on other risk factors — such as blood pressure, blood lipids and glucose metabolism — or examined associations of sleep quality with these outcomes,” Elsie Taveras, MD, MPH, chief of the Massachusetts General Hospital for Children division of general academic pediatrics, said in a press release. “An additional strength of our study is that we relied on an objective measurement of sleep, in contrast to subjective reports from parents or children that may be less accurate, and that it is also one of the first to focus on early adolescence — a developmental period with dramatic biological changes in sleep, a high incidence of inadequate sleep and the emergence of cardiovascular risk factors.”

Taveras and colleagues conducted a cross-sectional study of 829 adolescents (mean age, 13.2 years; 51.5% girls). They derived sleep duration, efficiency and moderate to vigorous physical activity from more than 5 days of wrist actigraphy recording for more than 10 hours per day.

The primary outcome was a metabolic risk score — defined as a mean of five sex-specific z scores for waist circumference, systolic BP, HDL scaled inversely, log-transformed triglycerides and a homeostatic model assessment of insulin resistance — for which higher scores indicated greater metabolic risk.

Socioeconomic status, race and/or ethnicity, pubertal status and obesity-related behaviors were all measured through the use of questionnaires.

Participants had a median sleep duration of 441.1 minutes per day and sleep efficiency of 84%.

It was also found that longer sleep duration was linked to lower metabolic risk scores (0.11 points; 95% CI, 0.19 to 0.02, per interquartile range), as was sleep efficiency (–0.08 points; 95% CI, –0.16 to –0.01). The associations persisted after adjustment for BMI z score and physical activity, television viewing and diet quality.

Longer sleep duration and greater sleep efficiency were also favorably linked to waist circumference, systolic BP, HDL and fat mass.

“Sleep quantity and quality are pillars of health alongside diet and physical activity,” Elizabeth Cespedes Feliciano, ScD, ScM, staff scientist at Kaiser Permanente Northern California Division of Research, said in the release. “Pediatricians should be aware that poor sleep quality — frequent awakenings and not just insufficient duration of sleep — is associated with increased cardiometabolic risk. While several trials have tried to extend the duration of sleep, few have targeted sleep efficiency and other aspects of sleep quality. We know that exercise improves sleep efficiency in adults and that screen time decreases it in children, so preventive measures should target those and other factors such as stress, noise and caffeine consumption.” by Dave Quaile

Disclosures: The authors report no relevant financial disclosures.

Longer sleep duration and higher sleep efficiency were linked to a favorable cardiometabolic profile in early adolescence, independent of other obesity-related behaviors, researchers reported.

According to the study published in Pediatrics, duration and the percentage of sleep that is undisturbed in young adolescents have a significant effect on CV health factors such as BP, cholesterol levels and abdominal fat deposition.

“While many studies have associated shorter sleep duration with increased obesity levels in children, few have examined effects on other risk factors — such as blood pressure, blood lipids and glucose metabolism — or examined associations of sleep quality with these outcomes,” Elsie Taveras, MD, MPH, chief of the Massachusetts General Hospital for Children division of general academic pediatrics, said in a press release. “An additional strength of our study is that we relied on an objective measurement of sleep, in contrast to subjective reports from parents or children that may be less accurate, and that it is also one of the first to focus on early adolescence — a developmental period with dramatic biological changes in sleep, a high incidence of inadequate sleep and the emergence of cardiovascular risk factors.”

Taveras and colleagues conducted a cross-sectional study of 829 adolescents (mean age, 13.2 years; 51.5% girls). They derived sleep duration, efficiency and moderate to vigorous physical activity from more than 5 days of wrist actigraphy recording for more than 10 hours per day.

The primary outcome was a metabolic risk score — defined as a mean of five sex-specific z scores for waist circumference, systolic BP, HDL scaled inversely, log-transformed triglycerides and a homeostatic model assessment of insulin resistance — for which higher scores indicated greater metabolic risk.

Socioeconomic status, race and/or ethnicity, pubertal status and obesity-related behaviors were all measured through the use of questionnaires.

Participants had a median sleep duration of 441.1 minutes per day and sleep efficiency of 84%.

It was also found that longer sleep duration was linked to lower metabolic risk scores (0.11 points; 95% CI, 0.19 to 0.02, per interquartile range), as was sleep efficiency (–0.08 points; 95% CI, –0.16 to –0.01). The associations persisted after adjustment for BMI z score and physical activity, television viewing and diet quality.

Longer sleep duration and greater sleep efficiency were also favorably linked to waist circumference, systolic BP, HDL and fat mass.

“Sleep quantity and quality are pillars of health alongside diet and physical activity,” Elizabeth Cespedes Feliciano, ScD, ScM, staff scientist at Kaiser Permanente Northern California Division of Research, said in the release. “Pediatricians should be aware that poor sleep quality — frequent awakenings and not just insufficient duration of sleep — is associated with increased cardiometabolic risk. While several trials have tried to extend the duration of sleep, few have targeted sleep efficiency and other aspects of sleep quality. We know that exercise improves sleep efficiency in adults and that screen time decreases it in children, so preventive measures should target those and other factors such as stress, noise and caffeine consumption.” by Dave Quaile

Disclosures: The authors report no relevant financial disclosures.