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Huang YC, Huang SH, Chung RJ, Wang BL, Chung CH, Chien WC, Sun CA, Yu PC, Lu CH. Obese Patients Experience More Severe CSA than Non-Obese Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031289. [PMID: 35162313 PMCID: PMC8835470 DOI: 10.3390/ijerph19031289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 12/04/2022]
Abstract
Objective: To investigate whether central sleep apnea (CSA) is associated with an increased risk of obesity. Materials and methods: From 1 January 2000 to 31 December 2015, we screened 24,363 obese patients from the 2005 longitudinal health insurance database, which is part of the Taiwan National Health Insurance Research Database. From the same database, 97,452 non-obese patients were also screened out. Age, gender, and index dates were matched. Multiple logistic regression was used to analyze the previous exposure risk of obese and CSA patients. A p-value of <0.05 was considered significant. Results: Obese patients were more likely to be exposed to CSA than non-obese patients would (AOR = 2.234, 95% CI = 1.483–4.380, p < 0.001). In addition, the closeness of the exposure time to the index time is positively correlated with the severity of obesity and has a dose–response effect (CSA exposure < 1 year, AOR = 2.386; CSA exposure ≥ 1 year and <5 years, AOR = 1.725; CSA exposure time ≥ 5 years, AOR = 1.422). The CSA exposure time of obese patients was 1.693 times that of non-obese patients. Longer exposure time is associated with more severe obesity and has a dose-response effect (CSA exposure < 1 year, AOR = 1.420; CSA exposure ≥ 1 year and <5 years, AOR = 2.240; CSA ≥ 5 years, AOR = 2.863). Conclusions: In this case-control study, patients with CSA had a significantly increased risk of obesity. Long-term exposure to CSA and obesity is more likely and has a dose-response effect.
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Affiliation(s)
- Yao-Ching Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan; (Y.-C.H.); (S.-H.H.); (R.-J.C.)
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan;
| | - Shi-Hao Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan; (Y.-C.H.); (S.-H.H.); (R.-J.C.)
| | - Ren-Jei Chung
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan; (Y.-C.H.); (S.-H.H.); (R.-J.C.)
| | - Bing-Long Wang
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan;
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taipei 11490, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan;
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taipei 11490, Taiwan
- Correspondence: (W.-C.C.); (C.-H.L.)
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan;
- Big Data Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan
| | - Pi-Ching Yu
- Graduate Institute of Medicine, National Defense Medical Center, Taipei 11490, Taiwan;
- Cardiovascular Intersive Care Unit, Department of Critical Care Medicine, Far-Eastern Memorial Hospital, New Taipei City 10602, Taiwan
| | - Chieh-Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: (W.-C.C.); (C.-H.L.)
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Kim H, Oh JH, Kim SM, Um YH, Seo HJ, Jeong JH, Hong SC, Kim TW. Effect of Delaying School Start Time on Sleep Quality, Emotions, and Performance in Korean Adolescents. SLEEP MEDICINE RESEARCH 2019. [DOI: 10.17241/smr.2019.00353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hart CN, Hawley NL, Wing RR. Development of a Behavioral Sleep Intervention as a Novel Approach for Pediatric Obesity in School-aged Children. Sleep Med Clin 2016; 11:515-523. [PMID: 28118874 DOI: 10.1016/j.jsmc.2016.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Despite being the focus of widespread public health efforts, childhood obesity remains an epidemic worldwide. Given the now well-documented consequences of obesity for childhood health and psychosocial functioning, as well as associated morbidity in adulthood, identifying novel, modifiable behaviors that can be targeted to improve weight control is imperative. Enhancing children's sleep may show promise in assisting with weight regulation. The present paper describes the development of a brief behavioral sleep intervention for school-aged children, including preliminary findings of this work as well as areas for future study.
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Affiliation(s)
- Chantelle N Hart
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, 3223 North Broad Street, Philadelphia, PA 19140, USA.
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA
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Hart CN, Hawley NL, Wing RR. Development of a Behavioral Sleep Intervention as a Novel Approach for Pediatric Obesity in School-aged Children. Pediatr Clin North Am 2016; 63:511-23. [PMID: 27261547 PMCID: PMC4893806 DOI: 10.1016/j.pcl.2016.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Despite being the focus of widespread public health efforts, childhood obesity remains an epidemic worldwide. Given the now well-documented consequences of obesity for childhood health and psychosocial functioning, as well as associated morbidity in adulthood, identifying novel, modifiable behaviors that can be targeted to improve weight control is imperative. Enhancing children's sleep may show promise in assisting with weight regulation. The present paper describes the development of a brief behavioral sleep intervention for school-aged children, including preliminary findings of this work as well as areas for future study.
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Affiliation(s)
- Chantelle N. Hart
- Center for Obesity Research and Education and Department of Social and Behavioral Sciences, College of Public Health, Temple University
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health
| | - Rena R. Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
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Aceves-Martins M, Llauradó E, Tarro L, Solà R, Giralt M. Obesity-promoting factors in Mexican children and adolescents: challenges and opportunities. Glob Health Action 2016; 9:29625. [PMID: 26787421 PMCID: PMC4718931 DOI: 10.3402/gha.v9.29625] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Mexico is a developing country with one of the highest youth obesity rates worldwide; >34% of children and adolescents between 5 and 19 years of age are overweight or obese. OBJECTIVES The current review seeks to compile, describe, and analyze dietary conditions, physical activity, socioeconomic status, and cultural factors that create and exacerbate an obesogenic environment among Mexican youth. DESIGN A narrative review was performed using PubMed and the Cochrane Library databases, as well as grey literature data from the Mexican government, academics, and statistical reports from nongovernmental organizations, included in electronic formats. RESULTS The recent socioeconomic and nutritional transition has resulted in reduced healthy meal options at public schools, high rates of sedentary lifestyles among adolescents, lack of open spaces and playgrounds, socioeconomic deprivation, false or misunderstood sociocultural traditional beliefs, misconceptions about health, a high percentage of overweight or obese adults, and low rates of maternal breastfeeding. Some of the factors identified are exacerbating the obesity problem in this population. Current evidence also shows that more policies and health programs are needed for prevention of childhood and adolescent obesity. Mexico presents alarming obesity levels, which need to be curtailed and urgently reversed. CONCLUSIONS The present narrative review presents an overview of dietary, physical activity, societal and cultural preconceptions that are potentially modifiable obesity-promoting factors in Mexican youth. Measures to control these factors need to be implemented in all similar developing countries by governments, policy makers, stakeholders, and health care professionals to tackle obesity in children and young people.
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Affiliation(s)
- Magaly Aceves-Martins
- Health Education and Promotion, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain
- Functional Nutrition, Oxidation and Cardiovascular Disease Research Group, Medicine and Surgery Department, Universitat Rovira i Virgili, Reus, Spain
| | - Elisabet Llauradó
- Health Education and Promotion, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain
- Functional Nutrition, Oxidation and Cardiovascular Disease Research Group, Medicine and Surgery Department, Universitat Rovira i Virgili, Reus, Spain
| | - Lucia Tarro
- Health Education and Promotion, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain
- Functional Nutrition, Oxidation and Cardiovascular Disease Research Group, Medicine and Surgery Department, Universitat Rovira i Virgili, Reus, Spain
| | - Rosa Solà
- Health Education and Promotion, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain;
- Functional Nutrition, Oxidation and Cardiovascular Disease Research Group, Medicine and Surgery Department, Universitat Rovira i Virgili, Reus, Spain
- Hospital Universitari Sant Joan, Centre Tecnològic de Nutrició i Salut, IISPV, Reus, Spain
| | - Montse Giralt
- Health Education and Promotion, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain
- Functional Nutrition, Oxidation and Cardiovascular Disease Research Group, Medicine and Surgery Department, Universitat Rovira i Virgili, Reus, Spain
- Unit of Pharmacology, Facultat de Medicina i Ciències de la Salut, Reus, Spain
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Child and Adolescent Sleep Patterns and Early School Start Times: Recognizing the Role of the Pediatric Nurse. J Pediatr Nurs 2015; 30:628-31. [PMID: 26021778 DOI: 10.1016/j.pedn.2015.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
The American Academy of Pediatrics recognizes insufficient sleep in adolescents as an important public health issue that significantly affects the health and safety, as well as the academic success, of our nation's middle and high school students. Although a number of factors, including biological changes in sleep associated with puberty, lifestyle choices, and academic demands, negatively affect middle and high school students' ability to obtain sufficient sleep, the evidence strongly implicates earlier school start times (ie, before 8:30 am) as a key modifiable contributor to insufficient sleep, as well as circadian rhythm disruption, in this population. Furthermore, a substantial body of research has now demonstrated that delaying school start times is an effective countermeasure to chronic sleep loss and has a wide range of potential benefits to students with regard to physical and mental health, safety, and academic achievement. The American Academy of Pediatrics strongly supports the efforts of school districts to optimize sleep in students and urges high schools and middle schools to aim for start times that allow students the opportunity to achieve optimal levels of sleep (8.5-9.5 hours) and to improve physical (eg, reduced obesity risk) and mental (eg, lower rates of depression) health, safety (eg, drowsy driving crashes), academic performance, and quality of life.
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Iglayreger HB, Peterson MD, Liu D, Parker CA, Woolford SJ, Sallinen Gafka BJ, Hassan F, Gordon PM. Sleep duration predicts cardiometabolic risk in obese adolescents. J Pediatr 2014; 164:1085-1090.e1. [PMID: 24612904 PMCID: PMC4121116 DOI: 10.1016/j.jpeds.2014.01.034] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/08/2013] [Accepted: 01/16/2014] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine the independent contributions of objectively measured sleep duration and fragmentation on cardiometabolic risk accumulation in free-living obese adolescents. STUDY DESIGN Characteristics of metabolic syndrome (waist circumference, mean arterial pressure, fasting high-density lipoprotein cholesterol, triglycerides, glucose) were measured in obese adolescents and standardized residuals (z-scores) were summed (inverse high-density lipoprotein cholesterol) to create a continuous cardiometabolic risk score (cMetScore), adjusted for age, sex, and race. Sleep and physical activity were objectively measured in habitual, free-living conditions for 7 days (SenseWear Pro3, BodyMedia, Pittsburgh, Pennsylvania; n = 37; 54% female, ages 11-17 years). Associations between sleep duration and cMetScore were assessed via multiple linear regression. RESULTS Body mass index, total sleep time, and sleep session length were each correlated with cMetScore (P < .05 all). Total sleep time was inversely and independently associated with cMetScore (r = -0.535, P = .001) and was the best independent predictor of metabolic risk. CONCLUSIONS Sleep duration inversely predicts cardiometabolic risk in obese adolescents, even when we controlled for various measures of physical activity, anthropometry, and adiposity. Further research should investigate the biological mechanism of this relationship and the potential treatment effect of sleep intervention in decreasing cardiometabolic risk in this population.
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Affiliation(s)
- Heidi B Iglayreger
- The Laboratory for Physical Activity and Exercise Intervention Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Mark D Peterson
- The Laboratory for Physical Activity and Exercise Intervention Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Dongmei Liu
- The Laboratory for Physical Activity and Exercise Intervention Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Christine A Parker
- The Laboratory for Physical Activity and Exercise Intervention Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Susan J Woolford
- Child Health Evaluation and Research Unit, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Bethany J Sallinen Gafka
- Division of Child Behavioral Health, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Fauziya Hassan
- Division of Pediatric Pulmonology, University of Michigan, Ann Arbor, MI; Michael S. Aldrich Sleep Disorders Center, University of Michigan, Ann Arbor, MI
| | - Paul M Gordon
- The Laboratory for Physical Activity and Exercise Intervention Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI; Department of Health, Human Performance and Recreation, Baylor University, Waco, TX.
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Abstract
OBJECTIVE Chronic insufficient sleep is a growing concern among adolescents and is associated with a host of adverse health consequences. Early school start times may be an environmental contributor to this problem. The purpose of this study was to examine the impact of a delay in school start time on sleep patterns, sleepiness, mood, and health-related outcomes. METHOD Boarding students (n = 197, mean age = 15.6 yr) attending an independent high school completed the School Sleep Habits Survey before and after the school start time was experimentally delayed from 8:00 a.m. to 8:25 a.m. RESULTS The delay in school start time was associated with a significant (29 min) increase in sleep duration on school nights. The percentage of students receiving 8 or more hours of sleep on a school night increased to more than double, from 18% to 44%. Students in 9th and 10th grade and those with lower baseline sleep amounts were more likely to report improvements in sleep duration after the schedule change. Daytime sleepiness, depressed mood, and caffeine use were all significantly reduced after the delay in school start time. Sleep duration reverted to baseline levels when the original (earlier) school start time was reinstituted. CONCLUSIONS A modest (25 min) delay in school start time was associated with significant improvements in sleep duration, daytime sleepiness, mood, and caffeine use. These findings have important implications for public policy and add to research suggesting the health benefits of modifying school schedules to more closely align with adolescents' circadian rhythms and sleep needs.
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Gonnissen HK, Adam TC, Hursel R, Rutters F, Verhoef SP, Westerterp-Plantenga MS. Sleep duration, sleep quality and body weight: Parallel developments. Physiol Behav 2013; 121:112-6. [DOI: 10.1016/j.physbeh.2013.04.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 04/03/2013] [Accepted: 04/15/2013] [Indexed: 01/29/2023]
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Azadbakht L, Kelishadi R, Khodarahmi M, Qorbani M, Heshmat R, Motlagh ME, Taslimi M, Ardalan G. The association of sleep duration and cardiometabolic risk factors in a national sample of children and adolescents: The CASPIAN III Study. Nutrition 2013; 29:1133-41. [DOI: 10.1016/j.nut.2013.03.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 02/18/2013] [Accepted: 03/05/2013] [Indexed: 12/21/2022]
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Sung V, Beebe DW, Vandyke R, Fenchel MC, Crimmins NA, Kirk S, Hiscock H, Amin R, Wake M. Does sleep duration predict metabolic risk in obese adolescents attending tertiary services? A cross-sectional study. Sleep 2011; 34:891-8. [PMID: 21731139 DOI: 10.5665/sleep.1122] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
STUDY OBJECTIVES To determine, in a clinical sample of obese adolescents, whether shorter sleep duration is associated with metabolic risk and obesity severity. DESIGN Cross-sectional study. SETTING Tertiary care weight-management clinic in Cincinnati, OH, USA. PARTICIPANTS 133 obese adolescents aged 10-16.9 years. INTERVENTIONS N/A. MEASUREMENTS Multifaceted sleep duration data were examined with fasting venipuncture and anthropometric data collected during clinical care. PRIMARY OUTCOME presence of metabolic syndrome. SECONDARY OUTCOMES waist circumference, triglycerides, HDL-cholesterol, blood pressure, glucose, insulin resistance (HOMA-IR), and body mass index (BMI). PREDICTORS Sleep duration by (1) parent-report, (2) self-report, and (3) multi-night actigraphy. ANALYSIS Relationships between sleep duration and each outcome were examined via regression models, adjusted for potential confounders. RESULTS Regardless of how measured, sleep duration showed no strong association with metabolic syndrome (OR 1.1 to 1.5, P = 0.2 to 0.8), BMI (β -0.03 to -0.01, P = 0.2 to 0.8), or most other outcomes. Lower triglycerides were predicted by shorter sleep duration by self-report (β 12.3, P = 0.01) and actigraphy (β 13.6, P = 0.03), and shorter parent-reported sleep duration was associated with higher HDL-cholesterol (β = -2.7, P = 0.002). CONCLUSIONS Contrary to expectations, sleep duration was not associated with metabolic outcomes, and showed limited associations with lipid profiles. Although inadequate sleep may affect other areas of functioning, it appears premature to expect that lengthening sleep will improve BMI or metabolic outcomes in clinical samples of obese adolescents.
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Affiliation(s)
- Valerie Sung
- Centre for Community Child Health, Royal Children’s Hospital and Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia.
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Abstract
The purpose of this review is to provide a comprehensive update of epidemiologic studies that have assessed the association between sleep and obesity risk. Data suggest that short sleep is associated with an increased risk for being or becoming overweight/obese or having increased body fat. Late bedtimes are also a risk factor for overweight/obesity. Findings also suggest that changes in eating pathways may lead to increased body fat. Future experimental studies are needed to enhance our understanding of the underlying mechanisms through which sleep may play a role in the development and maintenance of childhood obesity.
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Affiliation(s)
- Chantelle N. Hart
- Corresponding author for proof and reprints: Chantelle Hart, Ph.D., Weight Control & Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI 02903; ; 401-793-9727; 401-793-8944 (fax)
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Abstract
BACKGROUND Short sleep duration is associated with obesity during childhood and adulthood. OBJECTIVE The objective of our study was to investigate the relationship between sleep duration and body mass index (BMI) from Tanner stages 1 to 5 in a Dutch children cohort. DESIGN In 98 children, anthropometric measurements and leptin concentrations were measured from age 7 to 16 years; body composition, physical activity (Baecke questionnaire), hours television viewing and self-reported sleep duration were measured yearly from age 12 to 16 years. Moreover, the polymorphisms of the FTO gene (rs9939609) and parental BMI's were determined. RESULTS At Tanner stages 1-5 sex differences were observed in height, body weight, waist circumference, fat mass per squared meter height and leptin concentrations per kg fat mass. Inverse relationships were observed between the change in BMI (kg m(-2)) and the change in hours of sleep per night (h) from Tanner stages 1 to 4 (r=-0.68, P<0.001), from Tanner stages 2 to 5 (r=-0.35, P<0.05) and from Tanner stages 1 to 5 (r=-0.33, P<0.05). Univariate analysis of variance showed that with progressive Tanner stages, BMI increases and sleep duration decreases in an interrelated way independent of possible confounders (R(2)=0.38, P<0.02). CONCLUSION Changes in BMI during puberty were inversely related to changes in sleep duration, independent of possible confounders.
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O'Gorman CS, Simoneau-Roy J, Pencharz P, MacFarlane J, MacLusky I, Narang I, Adeli K, Daneman D, Hamilton J. Sleep-disordered breathing is increased in obese adolescents with craniopharyngioma compared with obese controls. J Clin Endocrinol Metab 2010; 95:2211-8. [PMID: 20332250 DOI: 10.1210/jc.2009-2003] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT Retrospective studies suggest that adolescents with craniopharyngioma and hypothalamic obesity have increased sleep-disordered breathing (SDB). OBJECTIVES The objectives of this study were to compare the prevalence of SDB in adolescents with craniopharyngioma-related obesity compared with body mass index (BMI)-matched controls and to explore possible relationships between SDB, insulin resistance, and adipocytokines. DESIGN This was a cross-sectional study of obese craniopharyngioma and obese control adolescents. SETTING Subjects were evaluated in the clinical investigation unit at the Hospital for Sick Children, Toronto. PATIENTS Fifteen patients with craniopharyngioma-related obesity and 15 BMI-matched controls were recruited and tested. INTERVENTIONS Each subject underwent fasting blood work, frequent sampled iv glucose tolerance test, polysomnography, and abdominal magnetic resonance imaging with calculation of visceral and sc adipose tissue. MAIN OUTCOME MEASURES Main measures included insulin sensitivity, sleep efficiency, and fragmentation. RESULTS Insulin sensitivity was lower in craniopharyngioma subjects compared with control subjects (0.96 +/- 0.34 vs. 1.67 +/- 0.7, P = 0.01). Sleep-onset latency (19.3 +/- 27.8 vs. 31.9 +/- 23.4, P = 0.03) and oxygen saturations (rapid eye movement sleep: 89.0 +/- 5.1 vs. 94.2 +/- 2.3, P < 0.001; non-rapid eye movement sleep: 88.4 +/- 5.6 vs. 94.3 +/- 1.5, P < 0.001) were lower in craniopharyngioma. Obstructive apnea-hypopnea index (OAHI) (7.5 +/- 9.0 vs. 1.5 +/- 1.5, P = 0.03) was higher in craniopharyngioma. Respiratory distress index and OAHI correlated negatively with adiponectin concentrations (r = -0.61, P = 0.03, r = -0.71, P = 0.006, respectively) in craniopharyngioma. On multiple regression, TNF-alpha and craniopharyngioma were independent positive predictors of sleep-onset latency and adiponectin and craniopharyngioma were significant predictors (negative and positive, respectively) of OAHI. CONCLUSIONS SDB is increased in adolescents with craniopharyngioma-related obesity compared with BMI-matched controls. Routine polysomnography should be considered in obese patients with craniopharyngioma and appropriate treatment initiated.
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Affiliation(s)
- Clodagh S O'Gorman
- Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada
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Uebele VN, Gotter AL, Nuss CE, Kraus RL, Doran SM, Garson SL, Reiss DR, Li Y, Barrow JC, Reger TS, Yang ZQ, Ballard JE, Tang C, Metzger JM, Wang SP, Koblan KS, Renger JJ. Antagonism of T-type calcium channels inhibits high-fat diet-induced weight gain in mice. J Clin Invest 2009; 119:1659-67. [PMID: 19451696 DOI: 10.1172/jci36954] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 04/01/2009] [Indexed: 11/17/2022] Open
Abstract
The epidemics of obesity and metabolic disorders have well-recognized health and economic burdens. Pharmacologic treatments for these diseases remain unsatisfactory with respect to both efficacy and side-effect profiles. Here, we have identified a potential central role for T-type calcium channels in regulating body weight maintenance and sleep. Previously, it was shown that mice lacking CaV3.1 T-type calcium channels have altered sleep/wake activity. We found that these mice were also resistant to high-fat diet-induced weight gain, without changes in food intake or sensitivity to high-fat diet-induced disruptions of diurnal rhythm. Administration of a potent and selective antagonist of T-type calcium channels, TTA-A2, to normal-weight animals prior to the inactive phase acutely increased sleep, decreased body core temperature, and prevented high-fat diet-induced weight gain. Administration of TTA-A2 to obese rodents reduced body weight and fat mass while concurrently increasing lean muscle mass. These effects likely result from better alignment of diurnal feeding patterns with daily changes in circadian physiology and potentially an increased metabolic rate during the active phase. Together, these studies reveal what we believe to be a previously unknown role for T-type calcium channels in the regulation of sleep and weight maintenance and suggest the potential for a novel therapeutic approach to treating obesity.
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Affiliation(s)
- Victor N Uebele
- Department of Sleep Research, Merck Research Laboratories, West Point, Pennsylvania 19486-0004, USA.
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Spicuzza L, Leonardi S, La Rosa M. Pediatric sleep apnea: early onset of the 'syndrome'? Sleep Med Rev 2008; 13:111-22. [PMID: 19058983 DOI: 10.1016/j.smrv.2008.07.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Obstructive sleep apnea is a common disorder in childhood, particularly in the last decade when an increased prevalence of obesity has been documented. The neurocognitive and behavioral problems associated with this disorder have been known for a long time. However, the increased knowledge of cardiovascular and metabolic complications in adults with sleep apnea has been followed by a better understanding of the systemic effects of upper airway obstruction in children. Obstructive sleep apnea (OSA) has been shown to induce autonomic imbalance in children and to affect blood pressure, cerebral blood flow and cardiac function in an early phase. OSA may also induce chronic systemic inflammation and may contribute to the development of metabolic syndrome in obese children. Very recent research indicates that in children primary snoring, the mildest form of the sleep-disordered breathing spectrum, may also be associated with morbidity. It is, therefore, likely that these respiratory sleep disorders do not simply influence children's' performance in private and social life, but may more seriously affect children's' health. The aim of this review is to outline early systemic complications of obstructive sleep apnea and primary snoring in infants and children.
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Affiliation(s)
- Lucia Spicuzza
- Department of Pediatrics, Bronchopneumology O.U., University of Catania, Catania, Italy.
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Hitze B, Bosy-Westphal A, Bielfeldt F, Settler U, Plachta-Danielzik S, Pfeuffer M, Schrezenmeir J, Mönig H, Müller MJ. Determinants and impact of sleep duration in children and adolescents: data of the Kiel Obesity Prevention Study. Eur J Clin Nutr 2008; 63:739-46. [PMID: 18665183 DOI: 10.1038/ejcn.2008.41] [Citation(s) in RCA: 137] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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