Short sleep and breathing disorders are indeendant risk factors for developing childhood obesity

DObesity among children has become a tremendous problem all over the world. It involves about 43 million children while in Europe alone it affects 5 million and 20 million of citizens under the age of 18. This disease may lead to an increased risk of bone fractures, cardiovascular diseases as well as diabetes and obesity in the adult life. That is why it is of great importance to search for variable risk factors, the modifications of which could allow for putting an end to the epidemic obesity among the youngest. A significant step has been made by scientists from Albert Einstein College of Medicine in New York. They have observed that both small number of hours of sleep and breathing problems during sleep are the independent risk factors for obesity in children.

The authors of the research focused on the analysis of the independent relationship between the duration of sleep and breathing problems during sleep in early childhood (at the age of 18 months, 2.5, 5.75 and 6.75 years) and the Body Mass Index (BMI) in the later stages of childhood and in the pubescent years (at the ages of 7, 10 and 15). The analysis of this particular period of life was supported by the previous research describing this time as being the most vital in the pathogenesis of the development of obesity.

Sleep Disordered Breathing (SDB) was monitored by the parents in household conditions. The most common forms to be described were: snoring, sleep apnea and breathing through an open mouth.

The main cause of SDB are the overgrown tonsils both palatal and pharyngeal. They might be removed by a surgical procedure or during a kriosurgery. The duration of sleep is usually conditioned by the behaviours introduced by the parents, nonetheless psycho-social factors are also very important. Normalisation of the length of sleep in tougher cases might be a more complicated task to achieve as it requires the cooperation of both the family and specialists such as a counsellor or social workers.

After a careful statistical analysis of the collected data the scientists observed that in comparison to children having no Sleep Disordered Breathing, children presenting with the symptoms at the age of 2.5 had a doubled risk of developing obesity at the ages of 7, 10 and 15, regardless of the duration of their sleep. On the other hand, children who developed breathing disorders later on (at the age of 5 or 6) had from 60 up to 80% higher chance of developing excessive body mass in the later stages of their development while short duration of sleep in 5 and 6-year olds proved to increase the risk of obesity at the age of 15 by about 60 to even 100%. Considering these data, the researchers have claimed that SDB and the duration of sleep must influence the organism in similar ways. And although they are both independent risk factors, their importance in the development of obesity is comparable.

The mechanisms through which SDB might cause obesity in children are not yet understood, however these disorders might contribute to chronic inflammation, insulin resistance, sleep pattern distortions and changes in the levels of hormones regulating hunger. Short sleep influences the organism of a child in a similar way to SDB, in this case however, an important role is played by the changes in the circadian rhythm as well as the organisation of activities during the day. The described sleep disorders might also lead to serious distortions in the development of a young individual, as they are the risk factors for neuro-behavioral changes in the later stages of a child development. Thus, children might present with hyperactivity, attention deficits and show special educational needs (SEN).

The discovery of the scientists from New York conducted on the basis of a longitudinal observation research allows, for the first time, for a firm and confident claim that short duration of sleep and Sleep Disordered Breathing are independent risk factors for the development of obesity together with its consequences in children. These observations will definitely allow for a much quicker elimination of these risk factors as well as the prevention of serious metabolic disorders in children which, in turn, will allow for a vast improvement of both their health and the quality of their lives. Due to that fact, a reduction in the governmental budget expenses associated with managing and curing obesity-related diseases will also become possible.

Autors: Krzysztof J. Jankowski, Monika Gruszczyńska, Paula Hołub, Anna Jankowska, Anna Boguszewska-Czubara

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