SLEEP PATTERNS AND OBESITY IN A POPULATION OF HIGH RISK SCHOOL-AGE CHILDREN

Purposes/Aims: To characterize the relationship between childhood obesity and sleep duration in a high-risk population of school-age children. Data was gathered from two school-based health centers in Michigan, one urban and one rural.

Rationale/Conceptual Basis/Background: Despite a public health focus on childhood obesity, the prevalence remains alarming, with 34.2% of 6-11 year olds in the overweight or obese categories (body mass index [BMI] ≥ 85^th percentile) nationwide. The Centers for Disease Control and Prevention (CDC) recommends at least ten hours of sleep per day for school-age children. Research demonstrates a potential link between insufficient sleep and obesity in both children and adults.

Methods: In this secondary data analysis, we will evaluate data about sleep habits collected in a study that trained school-based health center providers on childhood obesity guidelines. The HeartSmartKids™ survey was completed by 5- to 12-year-old children with the assistance of their parents during well-child or sports physical visits to the school-based health center. Hours of sleep nightly was calculated from child or parent-reported “normal” bed time and wake-up time. BMI percentile was calculated from standardized measurements of height and weight using the sex-specific CDC BMI-for-age growth charts. A chi-squared test was performed to compare the rates of overweight and obesity in urban and rural students who reported ten or more hours of sleep versus those who slept less than ten hours per night.

Results: Forty-seven rural and 62 urban HeartSmartKids™ surveys were completed. In this sample, 31.8% of rural youth and 50% of urban youth were obese (≥95^th percentile on CDC BMI-for-age growth charts) (p=0.08). An additional 14.9% of rural youth and 17.2% of urban youth were overweight (≥85^th to <95^th percentile on CDC BMI-for-age growth charts) (p=0.079). Mean age was 9.5 years in the rural group and 11.8 years in the urban group (p<0.001). The race/ethnicity of the rural group was 100% non-Hispanic white, while the urban group was 100% non-Hispanic black. Gender differences were nonsignificant (p=0.802). Bedtimes and wake-up times were variable across the sample, ranging from 8:00 PM to 11:00 PM, and 5:00 AM to 9:00 AM, respectively. Nocturnal sleep times range from 6 to 12 hours. Results characterizing sleep patterns and the relationships among weight, sleep duration/patterns and other factors are pending. It is expected that nocturnal sleep duration < 10 hours will be associated with higher rates of obesity, based upon a review of the literature.

Implications: Knowledge of factors that contribute to childhood obesity will help nurses in multiple settings address this significant public health issue. Parents and children may benefit from education about the importance of adequate sleep duration and regular sleep patterns in maintaining a healthy body weight.