Abstract
Reduced sleep duration has an almost linear correlation with excessive weight and
obesity in the pediatric population. This is especially true for the youngest population,
less so for adolescents, whereas later on, this relationship tends to become U-shaped
in middle-aged subjects. The level of physical activity is a crucial determinant of
this correlation, with sedentary life and low activity level supporting obesity and
poor quality sleep. Quality of life, school achievement, and emotional regulation
are highly impacted by the short sleep–excessive weight dyad, as well as cardiometabolic
indexes. The latter include blood pressure, glucose metabolism, and lipid profile,
which all appear to be negatively affected, albeit less consistently, and thus with
low quality evidence as far as the latest meta-analytic reviews are concerned. Obstructive
sleep apnea (OSA) in children is also associated with alteration of sleep structure
and with sleep fragmentation rather than sleep time reduction. Pediatric OSA recognizes
two main phenotypes, lean and obese, the latter mostly typical of older children/adolescents,
mainly males, with a more severe impact on inflammatory and metabolic indexes and
a scarce cure rate after therapeutic adenotonsillectomy. Expanding sleep time and
limiting obesity with appropriate sleep hygiene, adequate exercise levels, salutary
nutritional advice, and screen time reduction may represent viable preventive tools
to avoid more serious physical and mental consequences later in adult life.
Keywords
sleep duration - obesity - physical activity - insulin resistance - pediatric OSA
