Autonomic Dysfunction: A Possible Pathophysiological Pathway Underlying the Association Between Sleep and Obesity in Children At-Risk for Obesity
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While mounting evidence suggests that sleep plays an important role in the etiology of obesity, the underlying pathogenic pathways are complex and unresolved. Experimental sleep deprivation studies demonstrate sympathovagal imbalance, indicative of diminished parasympathetic activity and/or heightened sympathetic activity, is consequent to poor sleep. Further, obese children exhibit sympathovagal imbalance, particularly during the night, compared to non-obese children. The question remains whether sympathovagal imbalance is one potential pathophysiological pathway underlying the association between sleep and obesity. The aim of the present study was to examine whether sympathovagal imbalance contributed to the association between sleep and obesity in children. Participants included 564 children aged 10 to 12 years (M = 11.67, SD = 0.95; 43.5 % girls) from the QUALITY Cohort, a longitudinal study of children at-risk for the development of obesity. While children were at-risk due to confirmed parental obesity status, 57.7 % of children were of normal body mass index (5–85th percentile). Sleep duration, sleep timing, and sleep disturbances were based on child- and parent-report. Anthropometrics were measured for central adiposity (waist circumference) and body composition (body mass index, fat mass index). Sympathovagal imbalance was derived from heart rate variability spectral analyses. Estimated path coefficients revealed that sympathovagal imbalance partially contributed to the association between poor sleep (later bedtimes, sleep-disordered breathing) and obesity. These findings highlight the importance of better understanding sympathovagal imbalance and its role in the etiology and maintenance of obesity. Future research should consider investigating nocturnal sympathovagal balance in youth.
KeywordsChildren Obesity Sleep Heart rate variability Sympathovagal imbalance Autonomic dysfunction
Body mass index
Children’s Sleep Habits Questionnaire
Dual-energy X-ray absorptiometry
Fast Fourier Transform
This work was partly supported by the Canadian Institutes of Health Research (J. McGrath OCO-79897, MOP-89886, MSH-95353; D.C. Jarrin BO512201). The QUALITY Cohort is funded by the Canadian Institutes of Health Research (M. Henderson #MOP-119512; M. Lambert #OHO-69442, #NMD-94067, #MOP-97853), the Heart and Stroke Foundation of Canada (#PG-040291), and Fonds de la recherche en santé du Québec. Dr. Marie Lambert (July 1952–February 2012), pediatric geneticist and researcher, initiated the QUALITY Cohort. Her leadership and devotion to QUALITY will always be remembered and appreciated. Sincere thanks to the dedicated QUALITY Cohort staff, especially Catherine Pelletier (Coordinator), Ginette Lagacé, Natacha Gaulin-Marion, and Hugues Charron, without whom this research would not be possible. Finally, we are grateful to all the families that participate in the QUALITY Cohort.
Conflict of interest
None to disclose.
The QUALITY Cohort Collaborative Group designed and coordinated the study and collected measurements at clinic visits. J.J.M. and P.P. planned the study design and analysis of the ECG recordings. D.C.J. performed the statistical analyses. D.C.J. and J.J.M. conceived the research question, interpreted the findings, and wrote the manuscript.
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