In the Journals

Sleep disturbances influence BMI, dysglycemia in youths

Adolescents with overweight or obesity who report poor sleep quality or daytime sleepiness are more likely to have a higher BMI and HbA1c when compared with similar adolescents who do not report sleep disturbances, likely further increasing the risk for developing type 2 diabetes, according to findings published in Pediatric Diabetes.

Babak Mokhlesi

“Clinicians need to be aware that poor sleep quality and short sleep duration are prevalent, and some of the sleep disturbances are associated with obesity and worse glucose metabolism,” Babak Mokhlesi, MD, MSc, professor of medicine and director of the Sleep Disorders Center at the University of Chicago, told Endocrine Today.

In a cross-sectional study, Mokhlesi and colleagues analyzed data from 214 youths aged 10 to 19 years with overweight or obesity who were at risk for or recently diagnosed with type 2 diabetes (67% female; mean age, 14 years; mean BMI, 35.9 kg/m²; 54.7% with prediabetes; 27.6% with type 2 diabetes). The participants, who were screened as part of the Restoring Insulin Secretion (RISE) study, underwent a 2-hour oral glucose tolerance test and HbA1c measurement and completed the 26-item Sleep Disturbances Scale questionnaire to assess subjective sleep duration and quality and the 16-item Cleveland Adolescent Sleepiness questionnaire to assess daytime sleepiness. Researchers used linear regression models to evaluate independent associations between sleep variables and measures of glycemia, BMI and blood pressure.

Within the cohort, 57.5% reported sleeping less than 8 hours per night, 51% reported daytime sleepiness, 26% reported poor sleep quality and 30% had obstructive sleep apnea (OSA).

BMI Scale 
Adolescents with overweight or obesity who report poor sleep quality or daytime sleepiness are more likely to have a higher BMI and HbA1c when compared with similar adolescents who do not report sleep disturbances, likely further increasing the risk for developing type 2 diabetes.
Source: Shutterstock

Researchers found that daytime sleepiness was associated with a 0.2% higher HbA1c (95% CI, 0.031-0.35) and a 13.6 mg/dL higher 2-hour glucose value (95% CI, 0.11-27.15). Sleep duration, sleep quality and OSA risk were not associated with the glycemic outcomes; however, poor sleep quality was associated with a 2.9 kg/m² higher BMI (95% CI, 0.96-4.85), and high OSA risk was associated with a 2.83 kg/m² higher BMI (95% CI, 0.99-4.67).

“Sleep complaints and short sleep duration are quite prevalent in obese youth,” Mokhlesi said. “Habitual sleep duration of 8 hours or less was reported by 57.5% of the cohort, with one-fourth reporting sleeping less than 7 hours per night. One-half of the cohort had excessive daytime sleepiness and 26.1% reported poor sleep quality. High risk for OSA was reported in 29.7% of the youth sleep disturbances, such as short sleep duration, poor sleep quality and daytime sleepiness. Poor sleep quality and risk for OSA are associated with higher BMI, and daytime sleepiness is associated with poorer glycemia.”

Mokhlesi said further research assessing whether interventions designed to improve sleep duration and sleep quality can improve metabolic health in overweight and obese youths is required.

“Our analysis raises the possibility that sleep quality and daytime sleepiness, rather than sleep duration per se, are more relevant to greater weight and dysglycemia in youth,” the researchers wrote. – by Regina Schaffer

For more information:

Babak Mokhlesi, MD, MSc, can be reached at the University of Chicago, Department of Medicine, Section of Pulmonary and Critical Care Medicine, 5841 S. Maryland Ave., MC6076, Room M630, Chicago, IL 60637; email: bmokhles@medicine.bsd.uchicago.edu.

Disclosures: The authors report no relevant financial disclosures.

Adolescents with overweight or obesity who report poor sleep quality or daytime sleepiness are more likely to have a higher BMI and HbA1c when compared with similar adolescents who do not report sleep disturbances, likely further increasing the risk for developing type 2 diabetes, according to findings published in Pediatric Diabetes.

Babak Mokhlesi

“Clinicians need to be aware that poor sleep quality and short sleep duration are prevalent, and some of the sleep disturbances are associated with obesity and worse glucose metabolism,” Babak Mokhlesi, MD, MSc, professor of medicine and director of the Sleep Disorders Center at the University of Chicago, told Endocrine Today.

In a cross-sectional study, Mokhlesi and colleagues analyzed data from 214 youths aged 10 to 19 years with overweight or obesity who were at risk for or recently diagnosed with type 2 diabetes (67% female; mean age, 14 years; mean BMI, 35.9 kg/m²; 54.7% with prediabetes; 27.6% with type 2 diabetes). The participants, who were screened as part of the Restoring Insulin Secretion (RISE) study, underwent a 2-hour oral glucose tolerance test and HbA1c measurement and completed the 26-item Sleep Disturbances Scale questionnaire to assess subjective sleep duration and quality and the 16-item Cleveland Adolescent Sleepiness questionnaire to assess daytime sleepiness. Researchers used linear regression models to evaluate independent associations between sleep variables and measures of glycemia, BMI and blood pressure.

Within the cohort, 57.5% reported sleeping less than 8 hours per night, 51% reported daytime sleepiness, 26% reported poor sleep quality and 30% had obstructive sleep apnea (OSA).

BMI Scale 
Adolescents with overweight or obesity who report poor sleep quality or daytime sleepiness are more likely to have a higher BMI and HbA1c when compared with similar adolescents who do not report sleep disturbances, likely further increasing the risk for developing type 2 diabetes.
Source: Shutterstock

Researchers found that daytime sleepiness was associated with a 0.2% higher HbA1c (95% CI, 0.031-0.35) and a 13.6 mg/dL higher 2-hour glucose value (95% CI, 0.11-27.15). Sleep duration, sleep quality and OSA risk were not associated with the glycemic outcomes; however, poor sleep quality was associated with a 2.9 kg/m² higher BMI (95% CI, 0.96-4.85), and high OSA risk was associated with a 2.83 kg/m² higher BMI (95% CI, 0.99-4.67).

“Sleep complaints and short sleep duration are quite prevalent in obese youth,” Mokhlesi said. “Habitual sleep duration of 8 hours or less was reported by 57.5% of the cohort, with one-fourth reporting sleeping less than 7 hours per night. One-half of the cohort had excessive daytime sleepiness and 26.1% reported poor sleep quality. High risk for OSA was reported in 29.7% of the youth sleep disturbances, such as short sleep duration, poor sleep quality and daytime sleepiness. Poor sleep quality and risk for OSA are associated with higher BMI, and daytime sleepiness is associated with poorer glycemia.”

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Mokhlesi said further research assessing whether interventions designed to improve sleep duration and sleep quality can improve metabolic health in overweight and obese youths is required.

“Our analysis raises the possibility that sleep quality and daytime sleepiness, rather than sleep duration per se, are more relevant to greater weight and dysglycemia in youth,” the researchers wrote. – by Regina Schaffer

For more information:

Babak Mokhlesi, MD, MSc, can be reached at the University of Chicago, Department of Medicine, Section of Pulmonary and Critical Care Medicine, 5841 S. Maryland Ave., MC6076, Room M630, Chicago, IL 60637; email: bmokhles@medicine.bsd.uchicago.edu.

Disclosures: The authors report no relevant financial disclosures.