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Obesity continues to be a major public health issue. In adolescents, there are limited studies on the relationship between obesity and sleep duration. We found hypothesized that an average sleep duration of <6 h in adolescents was associated with obesity. Data were from the National Longitudinal Study of Adolescent Health (ADD Health); a survey of 90,000 youths, aged 12-18 years; surveyed in several waves. The sample population for our study was 13,568. Weighted multiple logistic regression was used to identify the relationship between obesity at Wave II and sleep duration, having adjusted for skipping breakfast ≥ 2/week; race, gender, parental income, TV ≥ 2 h per day, depression, and obesity at Wave I. At Wave I, the mean age was 15.96 ± 0.11 years; mean sleep hours were 7.91 ± 0.04. At Waves I and II, respectively, 10.6 and 11.2% of adolescents were obese. Adjusted analyses suggest that the effect of shortened sleep duration in Wave I was not significantly predictive of obesity in Wave II (P < 0.218). Longitudinally, depression and TV ≥ 2 h per day at Wave I was associated with a higher risk of obesity at Wave II in adjusted analyses. Depressed adolescents were almost twice as likely to be obese (OR = 1.84, 95% CI = 1.25-2.72); adolescents who watched TV ≥ 2 h per day were 37% more likely to be obese (OR = 1.37, 95% CI = 1.09-1.72). Environmental factors including TV ≥ 2 h per day and depression were significantly associated with obesity; shortened sleep duration was not. Future longitudinal studies in adolescents are needed to determine whether timing of television watching directly influences sleep patterns and, ultimately, obesity., (© 2010 European Sleep Research Society.)

Objectives: A high proportion of children with Down syndrome (DS) have the obstructive sleep apnea syndrome (OSAS). Although adults with DS have many predisposing factors for OSAS, this population has not been well studied. We hypothesized that OSAS is common in adults with DS, and that the severity of OSAS is worse in DS adults who are more obese., Design: Cohort study., Setting: Sleep laboratory., Participants: 16 adults with DS underwent evaluation for sleep disordered breathing., Interventions: Polysomnographic results were compared to a retrospective sample of adult patients referred for clinically suspected OSAS., Measurements and Results: Polysomnograms were abnormal in 94% of DS subjects. The median apnea hypopnea index (AHI) was 37/h (range 0-118). The median arterial oxygen saturation nadir was 75% (23% to 95%), and the median peak end-tidal CO2 was 58 (47-66) mm Hg. There was a significant correlation between body mass index and AHI (r = 0.53, p < 0.05). Sixty-three percent had an Epworth score > 10. The AHI and saturation nadir were significantly worse in DS than non-DS patients., Conclusions: Adults with DS frequently have OSAS, with obstructive apnea, hypoxemia, hypoventilation, and sleep fragmentation. The severity of OSAS correlated with obesity. We speculate that the complications of untreated OSAS (cardiovascular disease, increased mortality, and neurobehavioral morbidities including daytime sleepiness and impaired cognitive function) commonly overlap with the manifestations of DS and therefore may not elicit a prompt investigation in these patients. We speculate that OSAS is an important, but potentially treatable, cause of morbidity in adults with DS.

Sleep disorders are common in children. The sleep disturbances associated with these disease processes may impact neurodevelopment and result in daytime behavioral and cognitive changes. Currently, there are no precise methods to accurately assess sleep disruption in the pediatric age group. There is evidence that American Sleep Disorders Association (ASDA) arousals are insufficient markers of sleep disruption in children. Other techniques that have been used to assess sleep disruption include unconventional means of evaluating the electroencephalogram (EEG) during sleep and evaluating subcortical or autonomic activation. The aim of this review is to discuss the application of conventional and unconventional markers of sleep disruption in children.