High levels of sleep disturbance across early childhood increases cardiometabolic disease risk index in early adolescence: longitudinal sleep analysis using the Health Outcomes and Measures of the Environment study

Author:

Duraccio Kara McRae1ORCID,Xu Yingying23ORCID,Beebe Dean W24ORCID,Lanphear Bruce5,Chen Aimin6,Braun Joseph M7ORCID,Kalkwarf Heidi28ORCID,Cecil Kim M29ORCID,Yolton Kimberly23

Affiliation:

1. Department of Psychology, Brigham Young University , Provo, UT , USA

2. Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA

3. Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center , Cincinnati, OH , USA

4. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center , Cincinnati, OH , USA

5. Faculty of Health Sciences, Simon Fraser University , Burnaby, BC , Canada

6. Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine , Philadelphia, PA , USA

7. Department of Epidemiology, Brown University School of Public Health , Providence, RI , USA

8. Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center , Cincinnati, OH , USA

9. Department of Radiology, Cincinnati Children’s Hospital Medical Center , Cincinnati, OH , USA

Abstract

Abstract Study Objectives This study examines the impact of sleep duration, bedtime, and sleep disturbance during early childhood on the risk of cardiometabolic disorder (CMD) in early adolescence. Methods Within the Health Outcomes and Measures of Environment Study, we examined sleep patterns of 330 children from ages 2 to 8 years and the relationship of these sleep patterns with cardiometabolic risk measures at age 12 (N = 220). We used a group-based semi-parametric mixture model to identify distinct trajectories in sleep duration, bedtime timing, and sleep disturbance for the entire sample. We then examined the associations between sleep trajectories and CMD risk measures using general linear models using both an unadjusted model (no covariates) and an adjusted model (adjusting for child pubertal stage, child sex, duration of breastfeeding, household income, maternal education, and maternal serum cotinine). Results In the unadjusted and adjusted models, we found significant differences in CMD risk scores by trajectories of sleep disturbance. Children in the “high” disturbance trajectory had higher CMD risk scores than those in the ‘low’ disturbance trajectory (p’s = 0.002 and 0.039, respectively). No significant differences in CMD risk were observed for bedtime timing or total sleep time trajectories in the unadjusted or adjusted models. Conclusions In this cohort, caregiver-reported sleep disturbance in early childhood was associated with more adverse cardiometabolic profiles in early adolescence. Our findings suggest that trials to reduce CMD risk via sleep interventions—which have been conducted in adolescents and adults—may be implemented too late.

Funder

National Institute of Environmental Health Sciences

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Neurology (clinical)

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