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Adolescent sleep and obesity

Adolescent sleep and obesity. Geoff Kira. Origins of research. Project Energize 1 : Cluster randomised controlled study (2 years) Nutrition and physical activity Waikato primary schools.

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Adolescent sleep and obesity

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  1. Adolescent sleep and obesity Geoff Kira

  2. Origins of research • Project Energize1: • Cluster randomised controlled study (2 years) • Nutrition and physical activity • Waikato primary schools Table 1. Correlation coefficients (r, p-value) of body mass standard deviations scores (SDS) with baseline sleep 1www.projectenergize.org.nz

  3. Sleep and obesity in youth • Locard, E. et al. (1992). Int J Obes Rel Metab Dis. 16(10), 721-729. • von Kries, R. et al. (2002). Int J Obes Rel Metab Dis.26(5), 710-716. • Chaput, J. P. et al. (2006). Int J Obes. 30(7), 1080-1085. • Dieu, H. T. T. et al. (2007). Int J Ped Obes. 2(1), 40-50. • Nixon, G. M. et al. (2008). Sleep. 31(1), 71-78. • Bawazeer, N. M. et al. (2009). Obes. 17(12), 2251-2253. • Shaikh, W. A. et al. (2009). Ind J Comm Med. 34(3), 192-194. • Moseley, L., & Gradisar, M. (2009). Sleep. 32(3), 334-341.

  4. Sleep and obesity Sleep Reduced insulin sensitivity1,2 Appetite Leptin/ Ghrelin2,3 Reduced energy expenditure4 Food Intake5 Sedentary6 Obesity • Van Cauter, E. et al. (2007). Hormone Res. 67(SUPPL. 1), 2-9. • Spiegel, K. et al. (2005). J Appl Physiol. 99(5), 2008-2019. • Taheri, S. (2007). Int J Sleep Wakeful, 1(1), 20-29. • Knutson, K. L. and E. Van Cauter (2008). Ann NY Acad Sci 1129: 287-304. • Nedeltcheva, A. V. et al. (2009). Am J Clin Nut. 89(1), 126-133. • Must, A., & Parisi, S. M. (2009). Int J Obes, 33(S1), S82-S86.

  5. What is sleep? Two process model Process S Sleep load Process C Zeitgeber Light Dark

  6. What is sleep? 1 2 3 4 5 • Slow Wave Sleep (SWS) • Associated with declarative memory consolidation • REM – Rapid Eye Movement • Associated with emotional & procedural skill memories • Five stages of sleep • Each stage ~90 mins in duration • Non-REM Sleep • Stages 1 & 2 = lightest sleep states • Stages 3 & 4 = deep sleep Adapted from Blunden (2009). ACES Manual.

  7. What is sleep? Adapted from Ohayon et al. (2004). Sleep, 27(7), 1255-1273.

  8. The adolescent paradox • Biological tendency to sleep later • Melatonin is released later • Results in “phase delay”

  9. Sleep deprivation in teenagers 1. Lack of focus • Emotional fragility 2. Impaired school performance 7. Low frustration tolerance 3. Neuropsychological disorders 8. Lowered immune function 9. Increased stress 4. Reduced motor control 10. Weight gain 5. Disruption to family From: Blunden, S. (2009) ACES Teachers Manual

  10. Aims • Feasibility of a curriculum-based sleep education programme • Extend the duration of sleep in the sleep education group • Obtain student perspectives about the sleep education programme

  11. Pilot design and method • 1 school (2 classes) • Teacher facilitator • Sleep diaries, mood, hygiene, problems, knowledge • BMI, Accelerometry and MARCA • Exit interviews

  12. Intervention • Five sessions (50 minutes) • Supported by powerpoint slides • Education1: • Physiology • Consequences of sleep deprivation • Habits/hygiene • FAQ’s about sleep • Structure of sleep 1Blunden S. (2009). ACES Teachers Manual

  13. Sleep tools • Diary • 7-day diary • Knowledge • True/false questions about sleep • Morningness-Eveningness • Morningness-Eveningness questionnaire1 • Possible score: 10 to 43 • Baseline measure only 1Carskadon M.A. & Acebo C. (1992) Sleep Res 21:367.

  14. Sleep tools Table 1. Sleep parameter questionnaires 1Kandel DB & Davies M (1982). Arch Gen Psych. 39, 1205-1212. 2 Mastin D, Bryson J, Corwyn RF. (2006). J Behav Med. 29(3):223-7. 3Carskadon MA, Seifer R, & Acebo C. (1991). Sleep Res. 20:421.

  15. Baseline Table 2. Descriptives and baseline results of sleep study participants (mean and SD)

  16. Morningness/eveningness Table 3. Morningness scores between intervention groups

  17. Results – sleep duration I: 51 mins C: -11 mins I: 39 mins C: -31 mins

  18. Results - BMI I:0.3 kg.m2 C:0.3 kg.m2 I:-0.1 kg.m2 C:0.1 kg.m2

  19. Results - Mood I:-0.1 C:0.3 I:-1.5 C:0.0

  20. Results – mood and sleep hygiene r=0.66, p<0.001

  21. Conclusion • Feasibility dependent on school • Sleep duration can be extended • Curriculum-based programme dependent on staff • Participants wanted to know about sleep

  22. Future work • New intervention delivery options • Collaborations • Australia: Dr S. Blunden - Pediatric Sleep Clinic • New Zealand: Dr S-J. Paine – Sleep/Wake Centre • Funding • Exploration of sleep in Māori • Appetite regulation (Leptin/Ghrelin) • Online application

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