Sleep deprivation and obesity in children

This article explains that sleep deprived children are more likely to be obese than children who get enough sleep.

Tired and hungry. There is a reason why these two conditions seem to go together so easily.

A “well established” link in medical research suggests young children and infants who do not get enough sleep are likely to develop obesity —and a host of devastating related health conditions — before they enter their teen years.

And by then, reversing the obesity is almost impossible, health experts say.

A study published in May in the journal “Pediatrics” hypothesizes that children sleeping less in early childhood developed obesity by age 7.

But the findings — from researchers at Massachusetts General Hospital for Children — are hardly shocking, say local physicians.

While studies such as this are likely to be confirmed by additional research in the years ahead, the other non-controversial conclusion is that obese children who suffer from obstructive sleep apnea also experience a variety of health issues, according to Dr. Ignacio Tapia, a pediatric pulmonologist and sleep medicine specialist at the Sleep Center in The Children’s Hospital of Philadelphia.

Tapia notes that youngsters of normal weight who experience deep sleep and REM or rapid eye movement sleep find sleep restorative, resulting in benefit for everything from brain activity to hormone secretions.

But the obese often cannot attain deep sleep because of the apnea, a condition characterized by brief, numerous involuntary breathing pauses that prevent people from reaching restorative levels of slumber.

When children do not get the sleep they need, they are at risk for health, performance and difficulties in school; researchers find that sleep deficiencies in children can be misdiagnosed as attention-deficit or behavior disorders.

Young patients with sleep apnea can be treated effectively with surgery to remove their tonsils and adnoids but for obese children, such a procedure may not resolve the issue. Further treatment can involve wearing cumbersome masks that help regulate breathing.

“Remember when your grandparents told you you need to go to sleep to grow?” Tapia asked. “Well, that turned out to be true. Growth is associated with longer sleep. The people who sleep less (for example) may have less insulin secretion which can be related to diabetes and pre-diabetes.”

Since the 1800s, each generation has lived longer than the one that preceded it, said Tapia, also assistant professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Such longevity can be linked to the development of antibiotics and advances in cardiac care.

Now, this generation may be the one that loses ground, because of the epidemic of obesity, which is a complex issue relating to social and cultural issues as well and having income components, physicians say. Those who earn less may not have ready access to healthy foods while eating at fast-food chains has been made increasingly affordable, Tapia said. Portion size also is an issue in this country.

“We are seeing patients who are not a little big but really really big,” he said. “It is not rare to see patients who have doubled their ideal weight. They do not weigh 20 or 30 percent more but 100 percent more’’ than growth charts indicate.

The “Pediatrics” study measured the effect of sleep deficiencies over time, using data from Project Viva, a longitudinal research study of women and children that examines the effects of mothers’ diets and other factors during pregnancy and after birth.

Obesity “definitely spans all ages,” said Dr. Tina Rakitt, a pediatric gastroenterologist at the Unterberg Children’s Hospital at Monmouth Medical Center. But the study published in May “is unique enough to say the obesity and sleep link even exists in young children,” she added. “There are many reasons for that link. People who don’t sleep well tend to eat more and they tend to eat more of the wrong things.”

The battle is lost once children are old enough to select their own snacks or meals, unless they are taught correctly. Physicians say healthy eating must be established when children are infants and must be carried on by the family. Obesity does not exist in a vacuum, the experts said.

“The obesity epidemic is not only an adult problem; it is a adult-pediatric problem,” Rakitt said. “We are seeing more sleep apnea…That is a terrible one. Children are developing fatty liver disease. We are starting to see some kids with serious complications either in their childhood or young adult years.”

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