Sleep Variability and Nutrition Intake in Adolescents: The Penn State Child Cohort

Introduction: The association between habitual sleep patterns and nutrition intake is not fully understood, especially in adolescents. We investigated the association between habitual sleep duration and its variability with nutrition intake in population-based adolescents of the Penn State Child Cohort (PSCC) follow-up examination.

Methods: An actigraph (GT3X) and a sleep diary were used in 421 adolescents for 7 consecutive nights to calculate nightly sleep time and sleep efficiency. We then calculated within-subject 7-night means and the standard deviations (SDs). The means being used as the individual’s habitual sleep duration and efficiency. The SDs were used as the individual’s habitual variability of sleep duration and efficiency. Dietary habits and nutrition intake were assessed using a validated youth/adolescent food frequency questionnaire. Total intakes of energy (kcal), protein (g), fat (g), and carbohydrates (g) were analyzed. Linear regression models were used to evaluate the relationships between habitual sleep variables and nutrition intakes.

Results: The mean (SD) age was 16.7 y (2.3), with 52% male and 78% white. The mean (SD) habitual sleep duration and its variability were 7.00 h (0.83) and 1.16 h (0.58), respectively. The mean (SD) habitual sleep efficiency and its variability were 83% (6.3) and 7.01% (4.3), respectively. After adjusting for age, gender, and race, 1-hour increase in sleep-duration-variability, but not mean sleep duration, was associated with higher total energy intake (β+201.38, SE=64.45, p<0.01), higher total fat intake (β=6.38, SE=2.50, p=0.01), and higher carbohydrates intake (β=32.18, SE=8.79, p<0.01). Similarly, higher sleep-efficiency-variability, but not mean sleep efficiency, was significantly associated with higher energy, total fat, and carbohydrates intakes.

Conclusion: In adolescents, higher habitual sleep-duration-variability and sleep-efficiency-variability are associated with higher total energy intake, especially energies from fat and carbohydrates. These associations may contribute to obesity associated with sleep. Night-to-night sleep duration variability is a novel risk factor for increased food intake and obesity.

Support: NIH R01 HL63772, R01 HL97165, UL1 RR033184, C06 RR16499, UL TR000127