Longitudinal Analysis of Sleep Duration and Cardiometabolic Risk in Young Children

Background: The aim of this study is to determine if sleep duration in early childhood is associated with cardiometabolic risk (CMR) in later childhood as assessed by a CMR cluster score [sum of ageand sex-standardized z-scores of waist circumference (WC), systolic blood pressure, triglycerides, glucose, and (inverse) high-density lipoprotein (HDL)]. Secondary objectives included examining sleep duration and the individual CMR factors and BMI z-score. Patients and Methods: A prospective cohort study was conducted using data from the TARGet Kids! practice-based research network in Toronto, Canada. Children (n = 597) with parent-reported 24-hour sleep duration in early childhood (12–36 months) and a follow-up visit (36–96 months) with all five CMR factors were included in the analysis. Multivariable linear regression was used to assess the relationship between early childhood sleep duration and later childhood CMR, adjusting for relevant covariates. Results: Average 24-hour sleep duration in early childhood [mean age: 28.1 (6.6) months] was 11.8 (1.4) hours, with 87% meeting or exceeding total sleep recommendations for their age. Sleep duration in early childhood was not associated with the CMR cluster score in later childhood. Shorter sleep duration was associated with higher HDL concentrations [adjusted b = -0.028 (95% confidence interval: -0.049 to -0.007), p = 0.009]. Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Ontario, Canada. Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada. Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada. Division of Cardiology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada. Department of Pediatrics, St. Michael’s Hospital, Toronto, Ontario, Canada. *TARGet Kids! Collaboration—Co-Leads: Catherine S. Birken and Jonathon L. Maguire; Scientific Committee: Kawsari Abdullah, Yamna Ali, Laura N. Anderson, Imaan Bayoumi, Cornelia M. Borkhoff, Sarah Carsley, Shiyi Chen, Yang Chen, Denise Darmawikarta, Cindy-Lee Dennis, Karen Eny, Stephanie Erdle, Kayla Furlong, Kanthi Kavikondala, Christine Koroshegyi, Christine Kowal, Grace Jieun Lee, Dalah Mason, Jessica Omand, Patricia C. Parkin, Navindra Persaud, Lesley Plumptre, Meta van den Heuvel, Shelley Vanderhout, Peter Wong, and Weeda Zabih; Site Investigators: Murtala Abdurrahman, Barbara Anderson, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Nicholas Blanchette, Gary Bloch, Joey Bonifacio, Ashna Bowry, Anne Brown, Jennifer Bugera, Douglas Campbell, Sohail Cheema, Elaine Cheng, Brian Chisamore, Ellen Culbert, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Keewai Fung, Sharon Gazeley, Charlie Guiang, Dan Ha, Curtis Handford, Laura Hanson, Hailey Hatch, Teresa Hughes, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Tara Kiran, Lauren Kitney, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Eddy Lau, Fok-Han Leung, Alan Li, Jennifer Loo, Joanne Louis, Sarah Mahmoud, Roy Male, Vashti Mascoll, Rosemary Moodie, Julia Morinis, Maya Nader, Sharon Naymark, Patricia Neelands, James Owen, Jane Parry, Michael Peer, Kifi Pena, Marty Perlmutar, Navindra Persaud, Andrew Pinto, Tracy Pitt, Michelle Porepa, Vikky Qi, Nasreen Ramji, Noor Ramji, Jesleen Rana, Alana Rosenthal, Katherine Rouleau, Janet Saunderson, Rahul Saxena, Vanna Schiralli, Michael Sgro, Hafiz Shuja, Susan Shepherd, Hafiz Shuja, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Suzanne Turner, Fatima Uddin, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Peter Wong, Anne Wormsbecker, Ethel Ying, Elizabeth Young, Michael Zajdman, and Ian Zenlea. CHILDHOOD OBESITY August 2017 j Volume 13, Number 4 a Mary Ann Liebert, Inc. DOI: 10.1089/chi.2016. 0279