Association between Inadequate Sleep and Insulin Resistance in Obese Children

Objective

To analyze the relationships between sleep duration, obstructive sleep apnea syndrome (OSAS), and markers of insulin resistance in obese children.

Study design

Forty obese children were evaluated for sleep-related complaints. Each child underwent a polysomnogram, an oral glucose tolerance test (OGTT), and fasting lipid panel tests. Indices of insulin resistance (HOMA-IR and WBISI) and insulin secretion (IGI) were calculated based on the results of the OGTT. Markers of insulin resistance were compared among groups categorized according to polysomnogram results.

Results

Subjects with shorter sleep duration had higher fasting insulin, peak insulin, and HOMA-IR levels and lower WBISI levels, findings suggestive of insulin resistance. In contrast, differences in body mass index z scores were not observed. Subjects with OSAS (32 of 40 children) had higher triglyceride levels and HOMA-IR values than those without OSAS, but did not differ in sleep duration. Multiple linear regression analysis revealed that HOMA-IR was significantly correlated with age, sleep duration, and percentage of rapid-eye-movement sleep.

Conclusions

Insulin resistance in obese children is associated with short sleep duration and OSAS.

Abbreviations: AHI, Apnea/hypopnea index, BMI, Body mass index, CPAP, Continuous positive airway pressure, HOMA-IR, Homeostasis Model Assessment of Insulin Resistance, IGI, Insulinogenic index, IL, Interleukin, OGTT, Oral glucose tolerance test, OSAS, Obstructive sleep apnea syndrome, REM, Rapid eye movement, SWS, Slow-wave sleep, TNF, Tumor necrosis factor, WBISI, Whole Body Insulin Sensitivity Index