Impact of Childhood Obesity and Psychological Factors on Sleep.

Nazar Mazurak,Florian Junne,Michael Urschitz,Jessica Cook,Yvonne Ritze,Isabelle Mack,Alisa Weiland,Stephan Zipfel,Paul Enck

doi:10.3389/fpsyt.2021.657322

Abstract

The aim of the study was to analyze sleep duration and behaviors in relation to psychological parameters in children and adolescents with obesity seeking inpatient weight-loss treatment in comparison to normal-weight children, and whether or not these variables would improve during the time course of treatment. Sixty children or adolescents with overweight and obesity (OBE) and 27 normal-weight (NW) peers (age: 9–17) were assessed for subjective sleep measures through self-reported and parent-reported questionnaires, as well as body weight, body composition, and psychological questionnaires. The OBE participants were assessed upon admission and before discharge of an inpatient multidisciplinary weight-loss program. NW participants' data were collected for cross-sectional comparison. In comparison to NW, children and adolescents with OBE had a shorter self-reported sleep duration and had poorer sleep behaviors and more sleep-disordered breathing as reported by their parents. No change in sleep measures occurred during the inpatient treatment. Psychological factors including higher anxiety, depression, and destructive-anger-related emotion regulation were moderate predictors for unfavorable sleep outcomes, independent of weight status. Children with obesity had less favorable sleep patterns, and psychological factors influenced sleep in children, independent of weight. More research is needed on the relationship and direction of influence between sleep, psychological factors, and obesity, and whether they can be integrated in the prevention and management of childhood obesity and possibly also other pediatric diseases.

Highlights

Obesity has been declared a global epidemic by the World Health Organization, with incidents of overweight and obesity increasing globally and occurring earlier in the lifespan [1, 2]
Obesity is a multifactorial condition with a complex etiology, and disordered sleep patterns appear to be contributing to the complex interplay [3,4,5]
We showed that children and adolescents with the indication for inpatient weight-loss treatment have shorter sleep duration and are more impacted by poor sleep behaviors, daytime sleepiness, and sleep-disordered breathing than their normal-weight peers

Summary

Introduction

Obesity has been declared a global epidemic by the World Health Organization, with incidents of overweight and obesity increasing globally and occurring earlier in the lifespan [1, 2]. The consequences of childhood obesity are far reaching, impacting physical, emotional, and social wellbeing, as well as short-term and long-term comorbidities including cardiovascular, metabolic, respiratory, and orthopedic conditions [3]. There is significant focus worldwide on the prevention and treatment of obesity in children and adolescents. Obesity is a multifactorial condition with a complex etiology, and disordered sleep patterns appear to be contributing to the complex interplay [3,4,5]. Disordered sleep and short sleep duration have been found to be associated with obesity in studies in adult and child and adolescent populations [6,7,8].

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