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Sleep Duration in Children and Its Influence on Glucose

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Sleep is a highly complex physiological process that accounts for approximately 40% of a child’s life by the age of 18 years[1]. Obtaining sufficient sleep has been reported to be important for multiple aspects of health and well-being in children[1][2]. Recently, the National Center for Sleep Disorders issued a research plan that called for development of new measures of pediatric sleep to advance clinical outcomes in research[3]. Sleep is assessed in children with objective monitoring, sleep diaries, and questionnaires[4].

As children get older, sleep patterns change with later bedtimes and less parental involvement with the child’s sleep routine[5]. There have been conflicting reports that sleep has an influence on academic success[6], attention, memory, intelligence and behavioral responses[7], with most conclusions as mere statements not backed by any form of scientific evidence. A relation is also suspected between abnormal sleep patterns and having a decrease in rate of participation in activities outside of school and missing social or sportive activities[8]. The amount of sleep that a person needs varies from one person to another, but on average most children need nine hours of nightly sleep or more, depending on their age[4]. Glucose homeostasis is firmly controlled by insulin and also by leptin adipocytokines[9].

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These hormones act significantly on regulating adiposity and food intake in human beings[9][10]. A healthy system requires the proper functional state of the nerves, muscles and adipose tissues to maintain blood glucose level[11]. Blood glucose level can be used in clinical practice to detect the possibility of any disturbance which could be physiologic or pathologic. In West Africa, primary academic performance can be assessed using various examinations after each term or session. These examinations consist of questions from the syllabus of all courses taught in same term or session. This study investigated sleep duration in children and its influence on blood glucose homeostasis and primary examination performance.

Materials and Methods

Study Participants

This study sampled six hundred 600 children from a primary school within Asaba in Delta State, Nigeria. Every member of the population had an Equal Probability of Selection (EPS). The sample included male children of different ethnic and religious background aged between 10 to 12 years old, weighing 27-30kg. All participants were students receiving education in grade 3, 4, and 5 in same institution. The students, their teachers and parents were reached as a result of repeatedvisits by researchers.

Study Protocols

Questionnaires were filled out by selected students, the students’ teacher andparents. It involved questions about sleeping/wakeuptime, having problems with falling into sleep, taking naps in the daytime, waking up at night, having problems with waking up in the morning and daytime sleepiness with respect to the student.

The inclusion criteria include:

  • Human subjects
  • Students from same institution between grade 3 to 5
  • Age range; 10 to 12, body weight; 27-30kg
  • 85% attendance in school prior and throughout study period
  • Physically and mentally healthy

This study was conducted on human subjects and revealed the possible link between sleep pattern in children and blood glucose homeostasis, ingestive behavior and primary examination performance. If a child does not get enough sleep, he or she may exhibit behaviors typical of sleep deprivation[1][5]. Sleep deprivation may cause learning, behavior, and mood problems in children[3][8]. Ifpoor quality and quantity of sleep continues until adulthood, it may increase the risk of certain medical conditionslike hypertension (high blood pressure)[13], obesity, adult-onsetdiabetes and depression[14][15].

From the current investigation, sleep has an inversely proportional relationship with quantity of food ingested daily and blood glucose level but a directly proportional relationship with primary examination performance. The increase in quantity of food ingested during wakefulness may be as a result of the increased central and peripheral metabolic activities[16]and the increased demand for nutrients that serve as energy source as a compensatory response. Mental and physical activities deplete the body’s energy store. Food is ingested for replenishment in order to continue these normal processes[16][17]. The increase in blood glucose when sleep was between 12am to 6am may be as a result of hormonal changes. Recent investigations revealed the influence of circadian hormones on blood glucose[18][19]. Circadian hormones like melatonin inhibits insulin secretion and increases blood glucose level[18].

The biomolecular constituents of the food ingested at dinner period for groups c and d may have elicited insulin response, but this responses was probably inhibited by melatonin and this may have affected glucose homeostasis. This study is clear scientific evidence that late night meal ingestion prolongs increased blood glucose level by possible suppression insulin response. Glucose tolerance may be impaired if sleep duration is shortened. The test scores of groups a andbwas more impressive than c and d. Abnormally increased level of blood glucose in central nervous system slows learning and memory[19]. Prolonged wakefulness may enhance the release of the stress hormone, cortisol[16]. Consolidation of memory by the hippocampus is impaired by cortisol[12]. It has been reported that cortisol causes degeneration of hippocampal neurons. This study is in agreement with previous reports that night sleep duration of at least 9 hours may enhance intellectual capacity in children.

Conclusion

Sleep is a behavior exhibited as a natural periodic state of rest and is essential for normal physiologic and biochemical processes in children. This study revealed that sleep duration may determine ingestive behavior, blood glucose level and higher intellectual performance.

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