title: Impact of short sleep on metabolic variables in obese children with obstructive sleep apnea.
abstract: To analyze the association between sleep duration, metabolic variables, and insulin resistance in obese children with and without obstructive sleep apnea. The decline in sleep duration has paralleled a dramatic increase in the prevalence of obesity and diabetes, suggesting a mechanistic relationship.
  
  
  
  Retrospective, case series.
  
  
  
  Consecutive obese patients 3 to 12 years of age who underwent polysomnography (PSG) and a metabolic panel and who completed a 14-item sleep questionnaire were analyzed. All laboratory testing was conducted within 3 months of PSG. Total sleep times were obtained from the PSG and confirmed by the questionnaire.
  
  
  
  A total of 171 patients (55.0% male) were studied. All patients were obese (body mass index [BMI] z score > 95th percentile). Patients were categorized into three groups: short sleepers, borderline sleepers, and optimal sleepers. Eighty-six (50.3%) patients were short sleepers, 71 (41.5%) were borderline sleepers, and 14 (8.2%) were optimal sleepers. The mean BMI z score was 3.13 ± 1.3 in short sleepers, 3.3 ± 1.1 in borderline sleepers, and 3.5 ± 1.5 in optimal sleepers (P = .39). There was no statistical difference in high- and low-density lipoprotein levels (P = .21 and P = .76, respectively) and total cholesterol (P = .43) among subgroups. Triglycerides, blood glucose, insulin, and homeostasis model assessment-insulin resistance were significantly higher in short sleepers when compared to borderline or normal sleepers (P = .008, P < .001, P < .001, and P < .001, respectively).
  
  
  
  Short sleep duration was correlated with alterations in metabolic variables and insulin resistance in obese patients. This raises concern for development of comorbid conditions that can persist into adulthood.
  
  
  
  4 Laryngoscope, 127:2176-2181, 2017.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago.|Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine.
authors.forename: Bharat
authors.initials: B
authors.lastname: Bhushan
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago.
authors.forename: Bushra
authors.initials: B
authors.lastname: Ayub
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago.|Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Thompson
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago.|Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
authors.forename: Fizan
authors.initials: F
authors.lastname: Abdullah
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago.|Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine.
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Billings
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008074:Lipoproteins / Q000097:blood; D008297:Male; D063766:Pediatric Obesity / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D017286:Polysomnography; D012189:Retrospective Studies; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008074:Lipoproteins; D014280:Triglycerides; D002784:Cholesterol
keywords: Short sleep; childhood obesity; insulin resistance; obstructive sleep apnea