Associations Between Sleep Duration Patterns and Overweight/Obesity at Age 6

Objective: To investigate whether longitudinal sleep duration patterns during early childhood is a risk factor of overweight or obesity at school entry while controlling for a variety of obesogenic environmental factors. Design, Setting, and Participants: This is a prospective cohort study (March-December 1998 to December 2004) of a representative sample of infants born in 1997-1998 in the Canadian province of Quebec. Body mass index (BMI) was measured at ages 2.5 and 6 years. Sleep duration was reported yearly from 2.5 to 6 years of age by their mothers. Prenatal, postnatal (5 and 29 months), and lifestyle (6 y) potentially confounding factors for excess weight were assessed by interviews, questionnaires and hospital records. A group-based semiparametric mixture model was used to estimate developmental patterns of sleep duration. The relationship between sleep duration patterns and BMI was tested using multivariate logistic regression models to control for potentially confounding factors on 1138 children. Results: Four sleep duration patterns were identified: short persistent (5.2%), short increasing (4.7%), 10-hour persistent (50.7%), and 11-hour persistent (39.4%). After controlling for potentially confounding factors, the risk for overweight or obesity was almost 4.2 times higher for short persistent sleepers (odds ratio [OR], 4.2; 95% confidence interval [Cl], 1.6 to 11.1; P = 0.003) than for 11-hour persistent sleepers. Conclusions: Persistently short sleep duration (<10 h) during early childhood significantly increases the risk of excess weight or obesity in childhood, and appears to be independent of other obesogenic factors.