Aims: Large studies linking adolescents' objectively measured sleep duration and adiposity markers are lacking. We characterized sleep duration and its cross-sectional and longitudinal associations with adiposity markers in adolescence.
Methods and results: Seven-day accelerometry was performed in a cohort of adolescents enrolled in the SI! Program for Secondary Schools trial in Spain at approximately ages 12 (1216 adolescents, 49.6% girls), 14 (1026 adolescents, 51.3% girls), and 16 (872 adolescents, 51.7% girls) years. Participants were classified as very short sleepers (VSS; <7 h), short sleepers (SS; 7-<8 h), or recommended-time sleepers (RTS; 8-10 h). Adjusted associations between sleep duration and adiposity markers were analysed using generalized linear and Poisson models. At ∼12 years, 33.7% of adolescents met sleep recommendations, and this percentage decreased with advancing age (22.6% at ∼14 and 18.7% at ∼16 years). Compared with RTS, overweight/obesity prevalence ratios at ∼12, 14, and 16 years among SS were 1.19 [95% confidence interval (CI): 1.09-1.30], 1.41 (95% CI: 1.34-1.48), and 0.99 (95% CI: 0.77-1.26) and among VSS were 1.30 (95% CI: 1.28-1.32), 1.93 (95% CI: 1.41-2.64), and 1.32 (95% CI: 1.26-1.37). Compared with adolescents who always met sleep recommendations, the prevalence of overweight/obesity was ∼5 times higher in those never meeting recommendations or meeting them only once. Similar trends were observed for the waist-to-height ratio (P = 0.010) and fat mass index (P = 0.024).
Conclusion: Most adolescents did not meet sleep recommendations. Shorter sleep duration was independently associated with unfavourable adiposity markers, and such adverse impact was cumulative. Health promotion programmes should emphasize the importance of good sleep habits.
Keywords: Accelerometry; Child; Health promotion; Overweight; Schools.
This study used a wearable activity tracker to analyse sleep patterns and their association with adiposity markers in a large cohort of adolescents at ages 12, 14, and 16 years.At 12 years, only 34% of adolescents met sleep recommendations (eight or more hours of sleep per day), and this percentage decreased with advancing age (23% at 14 and 19% at 16 years). Adolescents sleeping <8 h a day were more likely to present overweight, obesity, or other adverse adiposity markers than their peers with sufficient sleep.The link between insufficient sleep and adverse adiposity markers was independent of energy intake and physical activity levels, indicating that sleep itself is important. Therefore, health promotion programmes for adolescents should emphasize the importance of good sleep habits.
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