Abstract P459: Socioeconomic Disadvantage and Adverse Childhood Events Associated With Risk of Obesity and Insufficient Sleep in Children

Abstract

Introduction: Obesity and sleep problems are risk factors for various health problems. Children with both obesity and sleep problems are more likely than children with only one condition to develop cardiometabolic disorders later in life. This study estimates the prevalence of children with obesity and insufficient sleep duration and examines related demographic and social economic factors for their co-occurrence among children in the United States. Methods: Data were from the 2019 and 2020 National Survey of Children’s Health (NSCH). The NSCH provides national and state-level data on the physical and emotional health of non-institutionalized American children 0-17 y of age. For this study, children 10-17 y without missing data in the study variables (N=35678) were included. Age-adjusted, sex-specific body mass index was classified as underweight (<5th percentile); normal weight (5th to <85th percentile); overweight (85th to <95th percentile); or obese (≥95th percentile). Age-appropriate sleep duration was defined according to American Academy of Sleep Medicine guidelines (nighttime sleep for ages 10-12 y=9-12 h; 13-17 y=8-10 h). Children who slept below the minimum recommended duration on an average weeknight in the past week were classified as having insufficient sleep. The main outcome was co-occurrence of obesity and insufficient sleep. Descriptive statistics, chi-square tests and logistic regression were used applying sampling weights to account for non-response and sampling procedures. Results: In NSCH, 16.3% of children had obesity and 34.7 % reported insufficient sleep with 7.4% of children having both conditions. Younger children (age 10-12 y) had higher prevalence of obesity with insufficient sleep (11.3%) compared to older children (age 13-17 y; 5%). Non-Hispanic Black and Hispanic children had higher prevalence of co-occurring obesity and insufficient sleep compared to non-Hispanic white children (11.4% and 11% vs 4.7%, respectively). Children in low-income households had higher prevalence (12.4%) of both obesity and insufficient sleep than higher-income counterparts (2.9%) as did children with parents reporting less than high school education compared to those with more highly educated parents (13.8 vs 5.3%). Children exposed to ≥2 adverse childhood experiences had higher prevalence than those without (10.3 vs 5%). Logistic regression analyses show all these factors were significantly associated with co-occurring obesity and insufficient sleep (p-values <0.001). Conclusion: Combined prevalence of obesity and insufficient sleep duration among children varied by age, race, poverty, exposure to childhood adversity, and parental education. The study findings call attention from policy makers, pediatricians, and researchers to these co-existing health problems in children and develop effective strategies to combat obesity and improve sleep health.