Pediatric obesity has been labeled an epidemic with approximately 33% of children 6-11 years old being either overweight or obese. This marks a dramatic increase in pediatric obesity in the last 20 years. During this same time period, the number of children with insufficient sleep has also risen. Current estimates show that over one-half of school age children have shortened sleep duration. Epidemiological studies have found that shortened sleep duration is associated with increased risk of obesity in children. Experimental studies with adults suggest that less sleep may lead to increased risk for obesity through changes in the neuroendocrine control of hunger and appetite, which may influence food intake. Despite this mounting evidence, to our knowledge, no studies have assessed how an intervention to increase sleep duration affects children's eating behaviors. Furthermore, research has largely neglected to understand how enhancing sleep duration may affect engagement in physical and sedentary activities. The proposed study will therefore build upon previous research by determining whether enhancing sleep duration in children leads to changes in eating and activity behaviors. One hundred four children 8-11 years old who sleep 9 1/2 hours or less each night will be enrolled. Children will be randomly assigned to 1 of 2 conditions: 1) optimize sleep or 2) control (no change in sleep). Families of children in the optimize sleep group will receive effective behavioral strategies to increase sleep duration. At baseline, 2-week and 2-month follow-up, the following will be gathered: sleep duration, dietary intake, physical and sedentary activity, the relative reinforcing value (RRV) of food (i.e., how hard children work for food rewards), and child height and weight. Primary study aims are as follows: 1) to determine if the optimize sleep intervention leads to increases in sleep duration at 2-month follow-up, and 2) to determine if increased sleep leads to changes in caloric intake and percent calories from fat at 2-month follow-up. Secondary study aims will assess changes in the RRV of food, engagement in physical and sedentary activities, and changes in children's zBMI.
The current application is directly relevant to public health. Pediatric obesity is a growing epidemic that has been associated with changes in sleep duration. Information on the effect of increased sleep duration on eating and activity behaviors would help determine whether enhancing children's sleep duration is an important factor for improving their eating and activity behaviors, and important for the prevention and treatment of childhood obesity.