Abstract MP090: Sleep Duration Predict Incident Obesity in Childhood and Adolescence: Meta-analysis of Prospective Studies

Abstract

Objectives: To assess the longitudinal evidence of a relationship between duration of sleep and both incidence of overweight and/or obesity and changes in body mass index in infants, children and adolescents. Methods: We performed a systematic search of publications using MEDLINE (1966-2016), EMBASE (from 1980), Web of Science (from 1945), the Cochrane Library and manual searches without language restrictions. Studies were included if they were prospective, had a follow up >1 year, had measured duration of sleep at baseline and assessed either incident cases of overweight and/or obesity or changes in body mass index prospectively. Relative risks (RR), regression coefficients (beta) and 95% C.I. were extracted and pooled using a random effect model. Sensitivity analyses and meta-regressions were performed, heterogeneity and publication bias were also assessed. Results: Overall, 41 studies provided 56 independent cohort samples, including 98,130 boys and girls aged 0-18 years (follow-up 1 to 27 years). Sleep duration was assessed by questionnaire, either to parents or to children, actigraphy or polysomnography. Body mass index (BMI) was measured in all participants. In the pooled analyses, short duration of sleep was associated with a greater risk of becoming overweight or obese (RR: 1.57; 95% CI 1.34, 1.85; p<10 -5 ; n=59,471). There was significant heterogeneity (I 2 =92%, p<0.001), accounted for by three studies (I 2 =3% after their removal) and evidence of publication bias (p=0.007). The effect size increased with age (infants 1.40 [1.19, 1.65]; early childhood 1.53 [1.33, 1.76]; middle childhood 2.23 [2.18, 2.27]; adolescence 1.30 [1.11, 1.53]; p for heterogeneity <10 -5 ). The effect was not associated with average length of follow-up (p=0.923) or quality (p=0.475). BMI decreased for every hour of increased sleep (pooled beta: -0.01; -0.03, 0.00 kg/m 2 per h, p=0.032; n=16,225). Conclusion: Short duration of sleep is a significant predictor of the development of overweight, obesity and weight gain from birth to adolescence.