Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis

Short sleep duration is considered a potential risk for overweight/obesity in childhood and adolescence. However, most of the evidence on this topic is obtained from cross-sectional studies; therefore, the nature and extent of the longitudinal associations are unclear. This study explores the prospective association between short sleep and overweight/obesity in young subjects. The MEDLINE, EMBASE, Pubmed, and CINAHL databases were searched for English-language articles, published until May 2014, reporting longitudinal association between sleep and body mass index (BMI) in children and adolescents. Recommendations of the Sleep Health Foundation were used to standardize reference sleep duration. Sleep category, with sleep duration less than the reference sleep, was considered as the short sleep category. Meta-analysis was conducted to explore the association between short sleep and overweight/obesity. A review of 22 longitudinal studies, with subjects from diverse backgrounds, suggested an inverse association between sleep duration and BMI. Meta-analysis of 11 longitudinal studies, comprising 24,821 participants, revealed that subjects sleeping for short duration had twice the risk of being overweight/obese, compared with subjects sleeping for long duration (odds ratio 2.15; 95% confidence interval: 1.64-2.81). This study provides evidence that short sleep duration in young subjects is significantly associated with future overweight/obesity.