title: Sleep characteristics and cardiovascular risk in children and adolescents: an enumerative review.
abstract: Cardiovascular risk factors develop in childhood and adolescence. This enumerative review addresses whether sleep characteristics, including sleep duration, continuity, quality, and daytime sleepiness, are associated with cardiovascular risk factors in young people. Thirty-nine studies were identified, which examined the following risk factors: metabolic syndrome, glucose and insulin, lipids, blood pressure, and cardiovascular responses to psychological stressors. Due to the availability of other reviews, 16 longitudinal studies of obesity published in 2011 and later were also included in this report. Excluded from the review were studies of participants with suspected or diagnosed sleep disorders and reports from sleep deprivation experiments. Combining studies, evidence was strongest for obesity, followed by glucose, insulin, blood pressure (especially ambulatory blood pressure), and parasympathetic responses to psychological stressors. There was little evidence for metabolic syndrome cluster, lipids, and blood pressure responses to psychological stressors. The more positive associations were obtained for studies that incorporated objective measures of sleep and that included adolescents. The foundational evidence is almost entirely cross-sectional, except for work on obesity. In summary, available evidence suggests that the associations between sleep characteristics and cardiovascular risk vary by risk factor. It is time to conduct studies to determine antecedent and consequent relationships, and to expand risk factors to include markers of inflammation.
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: matthewska@upmc.edu.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.affiliation: Department of Psychology, Rowan University, NJ, USA.
authors.forename: Elizabeth J M
authors.initials: EJ
authors.lastname: Pantesco
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000209:etiology*; D002648:Child; D006801:Humans; D007328:Insulin / Q000097:blood; D024821:Metabolic Syndrome / Q000150:complications; D009765:Obesity / Q000209:etiology; D012307:Risk Factors; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications
chemical_list: D007328:Insulin
keywords: Blood pressure; Cardiovascular risk factors; Children; Lipids; Obesity; Sleep