Geschatte leestijd: 3 minutenOverweight can lead to sleep apnea, among other things. This sleep disorder itself has a magnifying effect on overweight and its potential consequences such as diabetes and cardiovascular diseases. Researchers have recently demonstrated this connection in children.
Sleep Apnea and Overweight
There is a strong association between overweight and the development of sleep apnea. This increasingly common obstruction of the airways is often accompanied by loud snoring. In children, it may occur in 5 to 10 percent of children aged between 8 and 11 years old. Although the exacerbating effect of sleep apnea on overweight has been demonstrated, this was still unclear in children.
In a study conducted by researchers from Beth Israel Deaconess Medical Center (BIDMC), they were curious about the influence of maternal snoring on the child’s snoring and metabolism. This includes considering the child’s BMI and potential insulin resistance. The reason for this was the finding that this association had been demonstrated in some animal studies. For example, in a study where sleep apnea was simulated in rats by alternately inducing oxygen deficiency in heavily pregnant rats. Apart from the fact that this sounds a bit cruel when described this way, it turned out to be ‘effective’ as a research design. The children of these rats with simulated sleep apnea weighed more, ate more, had higher triglyceride levels in the blood, elevated resting insulin, and a worse cholesterol profile. Now the researchers wanted to investigate this association in humans.
For this purpose, the researchers conducted a large-scale and long-term study in which approximately 1,100 children were followed until puberty. With their research, they first demonstrated the vicious cycle between snoring and body weight in children. Both conditions exacerbate the other condition. Their findings were published in Metabolism [1].
Excess body weight and child snoring were each predictive of the other among the children and adolescence in this cohort, creating a vicious metabolic cycle. Our findings confirm the existence of a physiologic loop between worsening obesity and worsening sleep apnea, which in turn leads to worsening obesity and higher risk for diabetes and cardiovascular disease later in life.
Mantzoros, Director Human Nutrition Unit, Division of Endocrinology, Diabetes, and Metabolism, BIDMC
According to the researchers, this was the first time that the relationship between maternal snoring, child snoring, and the child’s metabolism were examined. They used data from Project Viva, a study for which pregnant women were invited, selected from a network of 34 clinics in Massachusetts, between 1999 and 2002. Mothers completed an annual questionnaire via email. Combined with blood samples and measurements taken at ages 7 and 10 of the child, this provided valuable information to the researchers. They obtained information about sleep times, how(much) TV was watched, how much fast food was eaten, how many sugary drinks were consumed, body composition and weight, blood sugar, cholesterol, insulin resistance, and risk factors in metabolism, among other things.
Unlike in rats, there was no association found in this study between maternal snoring and later metabolism of the child. However, they discovered that children who snore have a much higher chance of later overweight as a child and adolescent. Based on certain indicators, their chances of developing diabetes and cardiovascular diseases were also increased. Snoring was found to be associated with a higher BMI, a higher degree of abdominal fat, and higher levels of leptin (the ‘hunger hormone’) at a later age.
These results suggest that in children, early interventions including both targeted weight loss and appropriate treatments for OSA are critical to breaking this vicious cycle between poor sleep and obesity in order to prevent chronic disease later in life.
Discovering this vicious cycle between overweight and sleep apnea in children would have important implications. Among other things, because diabetes and its effects can occur earlier if overweight develops at a younger age.
In follow-up studies, the researchers want to test the effect of sleep apnea treatment on overweight to prevent diabetes and other metabolic problems.
References
- Olivia M. Farr, Sheryl L. Rifas-Shiman, Emily Oken, Elsie M. Taveras, Christos S. Mantzoros. Current child, but not maternal, snoring is bi-directionally related to adiposity and cardiometabolic risk markers: A cross-sectional and a prospective cohort analysis. Metabolism, 2017; 76: 70 DOI: 10.1016/j.metabol.2017.06.008
