0101 Greater Variability in Sleep Health is Associated with Obesogenic Appetitive Traits in 6-Year-Olds in the INSIGHT Study

Abstract Introduction Poor sleep health is associated with increased risk for childhood obesity, but the underlying mechanisms are unclear. Eating behaviors may play a role. We examined the association between appetitive traits and objectively-measured sleep variables in 6-year-old children. We hypothesized that poorer or more variable sleep health measures would be associated with higher levels of food approach traits (food responsiveness, enjoyment of food, emotional overeating, and desire to drink), and lower levels of satiety responsiveness. Methods Participants were from an observational long-term follow-up of INSIGHT, an RCT of a responsive parenting intervention for first-time mothers compared to a safety control intervention. At age 6 years, children wore wrist actigraphy (Spectrum Plus) for 7 days to assess sleep. Children with ≥3 valid days were included in analyses (n=167). Mothers completed the Children’s Eating Behavior Questionnaire to assess appetitive traits. Separate regression models examined the association between appetitive traits and sleep variables (M/SD of nighttime total sleep time (TST), onset, offset, and midpoint of sleep timing, and sleep maintenance efficiency), controlling for intervention group, child age, sex, and overweight status. Results Mean TST was unrelated to appetitive traits; greater variability (SD) in TST was associated with higher food responsiveness (B=0.008, p=0.03) and desire to drink (B=0.010, p=0.04). Mean sleep onset time was unrelated to appetitive traits, but greater variability in sleep onset time was associated with higher desire to drink (B=0.686, p=0.004). Higher mean sleep maintenance efficiency was associated with higher satiety responsiveness (B=0.035, p=0.04) and lower enjoyment of food (B=-0.053, p=0.008). Greater variability in sleep maintenance efficiency was associated with higher enjoyment of food (B=0.092, p=0.03) and lower satiety responsiveness (B=-0.089, p=0.01). Emotional overeating was unrelated to sleep variables, and sleep offset and midpoint were unrelated to appetitive traits. Conclusion Other than sleep efficiency, mean levels of sleep health appear unrelated to appetitive traits, but greater variability in sleep health measures were associated with higher levels of potentially obesogenic traits and lower levels of protective traits. Future studies should examine whether promotion of sleep regularity can improve regulation of eating behavior and reduce childhood obesity risk. Support (if any) R01DK088244, KL2TR002015