Association between obesity and sleep disorders in primary school children: a cross-sectional study
BACKGROUND The prevalence of obesity in primary school children in Jakarta has reached 14% in 2013. Among many disorders, obesity can cause sleep disorders. However, sleep disorders in children are often overlooked by parents, even though they can cause physical, social, and psychological impacts. Therefore, it is necessary to find the association between obesity and sleep disorders in primary school children.
METHODS This cross-sectional study was performed between July–September 2015 on 107 children attending Menteng 01 Primary School, Jakarta. Children's weight and height were measured and then their parents filled out the brief infant sleep questionnaire (BISQ). The collected data were analyzed using chi-square.
RESULTS In this study, 20.6% of the children were obese, which was higher than the prevalence of obesity in Jakarta. Meanwhile, sleep disorders occurred in 62.6% of children. Data about children’s sleep habits and parents’ opinion about their children’s sleep were obtained. It showed that snoring and parents’ opinion about sleep disorders were factors associated with children’s sleep disorder. Statistical analysis also showed a significant association between obesity and sleep disorders in children (p = 0.037).
CONCLUSIONS The incidence of obesity in primary school children is high and is associated with sleep disorders.
World Health Organization. Obesity and overweight [Internet]. 2015 [cited 2 Feb 2015]. Available from: http://www.who.int/mediacentre/factsheets/fs311/en/.
Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Riset kesehatan dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI; 2013. Indonesian.
Marfuah D. Durasi dan kualitas tidur hubungannya dengan obesitas pada anak sekolah dasar di kota Yogyakarta dan kabupaten Bantul [thesis]. Universitas Gajah Mada; 2013. Indonesian.
Hanifratiwi. Hubungan gangguan tidur terhadap kualitas hidup anak dengan obesitas [S1]. Universitas Diponegoro; 2013. Indonesian.
Wang G, Xu G, Liu Z, Lu N, Ma R, Zhang E. Sleep patterns and sleep disturbances among Chinese school-aged children: prevalence and associated factors. Sleep Med. 2013;14(1):45-52. https://doi.org/10.1016/j.sleep.2012.09.022
Centers for Disease Control and Prevention. Defining childhood obesity [Internet]. 2016 [cited 23 Mar 2017]. Available from: http://www.cdc.gov/obesity/childhood/defining.html.
Sadeh A. A brief screening questionnaire for infant sleep problems: validation and findings for an internet sample. Pediatrics. 2004;113(6):e570-7. https://doi.org/10.1542/peds.113.6.e570
Sleep foundation. How much sleep do we really need? [Internet]. 2015 [cited 23 Mar 2015]. Available from: http://sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need.
Sekartini R, Adi NP. Gangguan tidur pada anak usia bawah tiga tahun di lima kota di Indonesia. Sari Pediatri. 2006;7(4):188-93. https://doi.org/10.14238/sp7.4.2006.188-93
Zhang J, Li AM, Fok TF, Wing YK. Roles of parental sleep/wake patterns, socioeconomic status, and daytime activities in the sleep/wake patterns of children. J Pediatr. 2010;156(4):606-12. https://doi.org/10.1016/j.jpeds.2009.10.036
Wang Y, Lim H. The global childhood obesity epidemic and the association between socio-economic status and childhood obesity. Int Rev Psychiatry. 2012;24(3):176-88. https://doi.org/10.3109/09540261.2012.688195
Drenowatz C, Eisenmann JC, Pfeiffer KA, Welk G, Heelan K, Gentile D, et al. Influence of socio-economic status on habitual physical activity and sedentary behavior in 8- to 11-year old children. BMC Public Health. 2010;10:214. https://doi.org/10.1186/1471-2458-10-214
Nuutinen T, Ray C, Roos E. Do computer use, TV viewing, and the presence of the media in the bedroom predict school-aged children's sleep habits in a longitudinal study? BMC Public Health. 2013;13:684. https://doi.org/10.1186/1471-2458-13-684
Kim HY, Dhong HJ, Lee JK, Chung SK, Jung SC. Sleep quality and effects of position on sleep apnea in East Asian children. Auris Nasus Larynx. 2011;38(2):228-32. https://doi.org/10.1016/j.anl.2010.07.005
Kang KT, Chou CH, Weng WC, Lee PL, Hsu WC. Associations between adenotonsillar hypertrophy, age, and obesity in children with obstructive sleep apnea. PLoS One. 2013. 8(10):e78666. https://doi.org/10.1371/journal.pone.0078666
McDowall PS, Elder DE, Campbell AJ. Relationship between parent knowledge of child sleep, and child sleep practices and problems: a pilot study in a children's hospital cohort. J Paediatr Child Health. 2017;53(8):788-93. https://doi.org/10.1111/jpc.13542
Haryono A, Rindiarti A, Arianti A, Pawitri A, Ushuluddin A, Setiawati A, et al. Prevalensi gangguan tidur pada remaja usia 12-15 tahun di sekolah lanjutan tingkat pertama. Sari Pediatri. 2009;11(3):149-54. https://doi.org/10.14238/sp11.3.2009.149-54
McDowall PS, Galland BC, Campbell AJ, Elder DE. Parent knowledge of children's sleep: a systematic review. Sleep Med Rev. 2017;31:39-47. https://doi.org/10.1016/j.smrv.2016.01.002
Wahlstrom KL, Dretzke BJ, Gordon MF, Peterson K, Edwards K, Gdula J. Examining the impact of later high school start times on the health and academic performance of high school students: a multi-site study. Minnesota: Center for Applied Research and Educational Improvement University of Minnesota; 2014.
Natalita C, Sekartini R, Poesponegoro H. Skala gangguan tidur untuk anak (SDSC) sebagai instrumen skrining gangguan tidur pada anak sekolah lanjutan tingkat pertama. Sari Pediatri. 2011;12(6):365-72. https://doi.org/10.14238/sp12.6.2011.365-72
Dewald JF, Meijer AM, Oort FJ, Kerkhof GA, Bögels SM. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: a meta-analytic review. Sleep Med Rev. 2010;14(3):179-89. https://doi.org/10.1016/j.smrv.2009.10.004
Canapari CA, Hoppin AG, Kinane TB, Thomas BJ, Torriani M, Katz ES. Relationship between sleep apnea, fat distribution, and insulin resistance in obese children. J Clin Sleep Med. 2011;7(3):268-73.
Wakefield TL, Lam DJ, Ishman SL. Sleep apnea and sleep disorders. In: Flint PW, Haughey BH, Lund VJ, Niparko JK, Richardson MA, Robbins T, et al. Cummings Otolaryngology. 6th ed. United States: Elsevier; 2015.
Krishnan V, Patel S. Sleep apnea and obesity. Sleep Loss and Obesity. 2012:119-131. https://doi.org/10.1007/978-1-4614-3492-4_9
Owens JA. Sleep medicine. In: Kliegman RM, Stanton BF, StGeme JW, Schor ND, Behrman RE. Nelson textbook of pediatrics. 19th ed. United States: Saunders Elsevier; 2011.
Owens JA, Spirito A, McGuinn M, Nobile C. Sleep habits and sleep disturbance in elementary school-aged children. J Dev Behav Pediatr. 2000;21(1):27-36. https://doi.org/10.1097/00004703-200002000-00005
Copyright (c) 2019 Thong Felicia Melinda, Rini Sekartini
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.