Anxiety mediates the relationship between sleep onset latency and emotional eating in minority children
Research Highlights
►Sleep onset latency is positively associated with emotional eating. ►Trait anxiety mediated the sleep onset latency - emotional eating relationship. ►Emotional eating may be a link between sleep disturbance and obesity.
Introduction
Pediatric obesity continues to rise, despite public health prevention efforts (Levi, Gadola, & Segal, 2006). Further, minority children are at increased risk.(Ogden, Carroll, & Flegal, 2008) This epidemic highlights the need to identify mechanisms to supplement the traditional prevention efforts that focus solely on energy intake and expenditure. Sleep duration has recently been identified as a novel risk factor for overweight and obesity in youth (Agras et al., 2004, Ievers-Landis et al., 2008, Reilly et al., 2005) as well as adults (Kripke et al., 2002, Taheri et al., 2004, Vioque et al., 2000).
Sleep onset latency (SOL),1 or the amount of time it takes to fall asleep, can lead to short sleep, unless one is able to make up for a long SOL by delaying wake-up time. Research suggests that short sleep can lead to increased dietary intake, which in turn can lead to obesity. This relationship has been demonstrated through laboratory studies that reported increases in ghrelin, a hormone that stimulates hunger, decreases in leptin, a hormone that induces satiation (Spiegel et al., 2004, Taheri et al., 2004) and increased snacking/hunger following short sleep (Spiegel et al., 2004, Spiegel et al., 2003). Imaki and colleagues (2002) also found that irregular meal patterns and snacking were related to insufficient sleep.
Research also shows that various sleep disturbances can impact psychological health. Nearly 10 years ago, Roberts, Shema, Kaplan, and Strawbridge (2000)(Roberts et al., 2000) reported that almost all studies in adolescents that assessed psychological outcomes of sleep problems had found associations to depression. However recent extant literature on this subject is sparse. A twin study of 8-year old children found a correlation between parent-reported sleep and child-reported depressive symptoms(Gregory, Rijsdijk, Dahl, McGuffin, & Eley, 2006). Sleep disturbances have also been related to anxiety. In a prospective study, Gregory and colleagues (Gregory et al., 2005) showed that sleep problems in childhood were predictive of anxiety in adulthood (60% increased odds of being diagnosed with an anxiety disorder). A review of the literature reported substantial overlap in children reporting sleep disturbances, anxiety and depression (Chorney, Detweiler, Morris, & Kuhn, 2007). The study of these associations in minority youth may be particularly relevant, considering research reporting higher sleep deprivation in this group (Spilsbury et al., 2004).
Thayer (2001)(Thayer, 2001) posits that emotional eating occurs due to a state of “tense tiredness.” Thus, short sleep and related negative affective states may lead to eating in response to negative affect, or emotional eating. Psychosomatic Theory of Obesity posits that emotional eating (eating in order to deal with negative affective states, in the absence of hunger) contributes to obesity (Kaplan, & Kaplan, 1957). Therefore, this paper explores the inter-relationships among SOL, psychological functioning and emotional eating in minority children. We predict that SOL will be associated with negative affect and emotional eating.
Section snippets
Sample
Participants were 357 elementary school children from public and parochial schools in Los Angeles County. Third through fifth grade minority children provided cross-sectional data for the study. Student data for this study were taken from a larger study which aimed to validate the use of psychosocial scales developed for older, non-minority populations for minority children.
Recruitment and procedures
School selection was based upon the ethnic makeup of the school, in order to obtain a predominantly Latino and African
Results
Characteristics of the sample are reported in Table 1. The sample was of diverse ethnic background, with nearly 60% being female. Forty-one percent of students were in 5th grade, 34% in 3rd grade and 25% in 4th grade. There were no significant ethnic differences in any of the variables used in these analyses (data not shown).
Multi-level regression analyses revealed associations among sleep onset latency, anxiety, depression, and emotional eating. Specifically, SOL showed statistically
Discussion
The present study aimed to test relationships among sleep onset latency, psychological constructs and emotional eating. As hypothesized, and consistent with the literature that shows sleep disturbance is associated with anxiety and depression (e.g. Gregory et al., 2005, Gregory et al., 2006), we found a positive association between SOL and both negative affect (anxiety and depression) and emotional eating. Further analyses revealed that anxiety fully mediated the relationship between SOL and
Role of funding sources
This work was performed at the University of Southern California and was supported by the NCI-funded USC Center for Transdisciplinary Research on Energetics and Cancer (U54 CA 116848). NCI did not have a role in study design, collection, analysis, interpretation of data, writing the manuscript, or the decision to submit the manuscript for publication.
Contributors
Authors Rodriguez and Metz designed the study and wrote the protocol. Author McClain assisted in study recruitment and data collection. Author Rodriguez conducted the statistical analyses. Author Rodriguez wrote the first drafts of the manuscript, and all authors contributed to and have approved the final manuscript.
Conflict of interest
All authors declare that they have no conflicts of interest.
Acknowledgements
We would like to thank the LAUSD, AUSD and the Roman Catholic Archdiocese for their continued support of our research. Special thanks to all of our participants and to our fellow lab members who volunteered to assist in data collection as well as our data entry staff.
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