title: No independent association between insufficient sleep and childhood obesity in the National Survey of Children's Health.
abstract: BACKGROUND
  Prior studies have supported an association between insufficient sleep and childhood obesity, but most have not examined nationally representative samples or considered potential sociodemographic confounders.
  
  
  OBJECTIVE
  The main objective of this study was to use a large, nationally representative dataset to examine the possibility that insufficient sleep is associated with obesity in children, independent of sociodemographic factors.
  
  
  METHODS
  The National Survey of Children's Health is a national survey of U.S. households contacted by random digit dialing. In 2003, caregivers of 102,353 US children were surveyed. Age- and sex-specific body mass index (BMI) based on parental report of child height and weight, was available for 81,390 children aged 6-17 years. Caregivers were asked, "How many nights of sufficient sleep did your child have in the past week?" The odds of obesity (BMI ≥ 95th percentile) versus healthy weight (BMI 5th-84th percentile) was regressed on reported nights of sufficient sleep per week (categorized as 0-2, 3-5, or 6-7). Sociodemographic variables included gender, race, household education, and family income. Analyses incorporated sampling weights to derive nationally representative estimates for a 2003 population of 34 million youth.
  
  
  RESULTS
  Unadjusted bivariate analyses indicated that children aged 6-11 years with 0-2 nights of sufficient sleep, in comparison to those with 6-7 nights, were more likely to be obese (OR = 1.7, 95% CI [1.2-2.3]). Among children aged 12-17 years, odds of obesity were lower among children with 3-5 nights of sufficient sleep in comparison to those with 6-7 nights (0.8, 95% CI: 0.7-0.9). However, in both age groups, adjustment for race/ethnicity, gender, family income, and household education left no remaining statistical significance for the association between sufficient nights of sleep and BMI.
  
  
  CONCLUSIONS
  In this national sample, insufficient sleep, as judged by parents, is inconsistently associated with obesity in bivariate analyses, and not associated with obesity after adjustment for sociodemographic variables. These findings from a nationally representative sample are necessarily subject to parental perceptions, but nonetheless serve as an important reminder that the role of insufficient sleep in the childhood obesity epidemic remains unproven.
authors.affiliation: Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI, USA. fhas@med.umich.edu
authors.forename: Fauziya
authors.initials: F
authors.lastname: Hassan
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Davis
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Chervin
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000209:etiology*; D012737:Sex Factors; D012892:Sleep Deprivation / Q000150:complications* / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology