Reduced Slow Wave Sleep Is Associated with Increased Risk of Short Stature in Children: A Cross-Sectional Study.

Objective: Although growth hormone was shown to be specifically released during slow wave sleep (SWS), no population-based evidence has demonstrated the association between sleep quality and childhood height. To address this gap, our study aims to investigate the relationship between SWS and height of children. Methods: We analyzed polysomnography data and z-scores for height in 2527 suspected obstructive sleep apnea (OSA) children (537 non-OSA children and 1990 OSA children) collected over the past 16 years. Different grades of z-scores for height and SWS were classified by the quartile method, and the lowest z-scores for height quartile defined short stature as the main outcome. Logistic regression models were used to assess the relationship between SWS and short stature. Results: 1990 OSA children and 537 non-OSA children were included in analyses. The mean value of z-score for height from high to low were 0.80, 0.34, 0.23 and -0.19 in non-OSA children, and 0.47, 0.10, 0.14 and 0.05 in OSA children. Fully adjusted logistic regression models showed that, compared to the highest SWS quartile, the lowest quartile had 4.85-fold higher odds (95% CI, 2.4-9.4) of short stature in non-OSA children and 2.15-fold higher odds (95% CI, 1.5-3.0) in OSA children. Subgroup analyses demonstrated that in both non-OSA and OSA children, the reduction of SWS was significantly related to short stature in prepubertal children. Linear regression models confirmed positive correlations between SWS and z-score for height. Conclusion: Our findings emphasize the crucial role of adequate sleep quality in childhood growth and development, supporting the inclusion of sleep assessments and improvements in pediatric growth monitoring programs.