Sleep habits and weight status in Brazilian children aged 4-6 years of age: the PREDI study

Lidiane Ferreira Schultz; Silmara Salete de Barros Silva Mastroeni; Renatha El Rafihi-Ferreira; Marco F Mastroeni

doi:10.1016/j.sleep.2021.08.020

Sleep habits and weight status in Brazilian children aged 4-6 years of age: the PREDI study

Sleep Med. 2021 Nov:87:30-37. doi: 10.1016/j.sleep.2021.08.020. Epub 2021 Aug 30.

Authors

Lidiane Ferreira Schultz¹, Silmara Salete de Barros Silva Mastroeni², Renatha El Rafihi-Ferreira³, Marco F Mastroeni⁴

Affiliations

¹ Postgraduate Program in Health and Environment, University of Joinville Region, Rua Paulo Malschitzki, nº 10, Joinville, SC, CEP 89.219-710, Brazil.
² Health Sciences Department, University of Joinville Region - UNIVILLE, Joinville, SC, Brazil.
³ Ambulatório de Sono (LIM-63), Instituto de Psiquiatria, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
⁴ Postgraduate Program in Health and Environment, University of Joinville Region, Rua Paulo Malschitzki, nº 10, Joinville, SC, CEP 89.219-710, Brazil; Health Sciences Department, University of Joinville Region - UNIVILLE, Joinville, SC, Brazil. Electronic address: marco.mastroeni@univille.br.

PMID: 34508985
DOI: 10.1016/j.sleep.2021.08.020

Abstract

Objectives: To evaluate the association of sleep habits with the weight status of children aged 4-6 years.

Methods: Data were obtained from the PREDI Study, a Brazilian birth cohort study. The current study was carried out in the homes of the participants during two follow-ups: 2016/17 and 2018. The participants were submitted to anthropometric assessment and demographic, socioeconomic and sleep data were obtained. The child's sleep habits were self-reported by the mother or caregiver on the day of the visit and included information on the following sleep habits during the past week: bedtime routine, rhythmicity, and separation affect determined with the Sleep Habits Inventory for Preschool Children and the Sleep Habits Inventory. Logistic regression and gamma-log regression analyses were used to examine the association of sleep habits with excess body weight of children in the two follow-ups according to sex.

Results: Of the 217 and 185 children included in 2016/17 and 2018, respectively, 66 (30.6%) and 48 (25.9%) had a BMI >85th percentile at 4-6 years, respectively. The median rhythmicity score was higher in children with excess body weight (p = 0.05). Adjusted analysis showed that rhythmicity was associated with excess body weight of girls at ages 4-5 years (OR = 1.42, 95% CI: 1.09-1.86, p = 0.009) and 6 years (OR = 1.32, 95% CI: 1.06-1.65, p = 0.015), even after adjustment for other important covariates. Additionally, the sleep habit "separation affect" was inversely associated with the child's BMI in boys (β = -0.005, 95% CI: -0.010-0.000, p = 0.037).

Conclusions: In the present study, rhythmicity problems were associated with increased odds of girls aged 4-6 years having excess body weight. These results are important from a public health perspective since strategies aimed at preventing excess body weight in children need to consider the child's sleep quality as a potential risk factor, especially rhythmicity.

Keywords: Bedtime routine; Children; Rhythmicity; Separation affect; Sleep habits.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Birth Cohort
Body Mass Index*
Brazil / epidemiology
Child
Child, Preschool
Cohort Studies
Female
Habits
Humans
Male
Sleep Quality*
Sleep*