• Elizabeth M Cespedes, Sheryl L Rifas-Shiman, Susan Redline, Matthew W Gillman, Michelle-Marie Peña, and Elsie M Taveras.
• Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA; Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
• Obesity (Silver Spring). 2014 Dec 1;22(12):2586-92.

ObjectiveTo examine associations of chronic insufficient sleep with mid-childhood cardiometabolic health.MethodsAt 6 months and yearly from 1 to 7 years, mothers participating in the Project Viva cohort reported children's 24-h sleep duration. The main exposure was a sleep curtailment score, ranging from 0 (maximal curtailment) to 13 (never having curtailed sleep). The main outcome was a mid-childhood metabolic risk score, derived as the mean of five sex- and cohort-specific z scores for waist circumference, systolic blood pressure, HDL cholesterol (scaled inversely), and log-transformed triglycerides and HOMA-IR; higher scores indicate higher risk.ResultsThe mean (SD) sleep score was 10.0 (2.8); 5.1% scored 0-4, 13.9% scored 5-7, 14.1% scored 8-9, 28.7% scored 10-11, and 38.3% scored 12-13. Mean (SD, range) metabolic risk score was -0.03 (0.6, -1.8 to 2.6). In multivariable models, the metabolic risk score difference for children with most versus least curtailed sleep was 0.29 units (95% confidence interval [CI]: 0.02, 0.57). Further adjustment for mid-childhood BMI z score attenuated this difference to 0.08 units (95% CI: -0.14, 0.30).ConclusionsChronic insufficient sleep from infancy to school-age was associated with higher mid-childhood metabolic risk. This association was explained by sleep duration's influence on mid-childhood adiposity.© 2014 The Obesity Society.

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