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Does an intervention that improves infant sleep also improve overweight at age 6? Follow-up of a randomised trial
  1. Melissa Wake1,2,3,
  2. Anna Price1,2,
  3. Susan Clifford1,2,
  4. Obioha C Ukoumunne2,3,
  5. Harriet Hiscock1,2,3
  1. 1Centre for Community Child Health, Royal Children's Hospital, Parkville, Victoria, Australia
  2. 2Murdoch Childrens Research Institute, Parkville, Victoria, Australia
  3. 3Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
  1. Correspondence to Professor Melissa Wake, Centre for Community Child Health, Royal Children's Hospital, Flemington Road, Parkville, VIC 3052, Australia; melissa.wake{at}


Objective Short sleep duration may contribute to childhood obesity. Amenable to intervention, sleep thus provides a potential path for prevention. The authors aimed to determine the impact of a behavioural intervention that successfully reduced parent-reported infant sleep problems on adiposity at age 6.

Design 5-year follow-up of a previously reported population-based cluster randomised trial. Participant allocation was concealed to researchers and data collection blinded.

Setting Recruitment from well-child centres in Melbourne, Australia.

Participants 328 children (174 intervention) with parent-reported sleep problems at age 7–8 months drawn from 49 centres (clusters).

Intervention Behavioural sleep strategies delivered over one to three structured individual nurse consultations from 8 to 10 months, versus usual care.

Main outcomes at age 6 years Body mass index (BMI) z-score, percentage overweight/obese and waist circumference.

Analyses Intention-to-treat regression analyses adjusted for potential confounders.

Results Anthropometric data were available for 193 children (59% retention) at age 6. There was no evidence of a difference between intervention (N=101) and control (N=92) children for BMI z-score (adjusted mean difference 0.2, 95% CI −0.1 to 0.4), overweight/obese status (20% vs 17%; adjusted OR 1.4, 95% CI 0.7 to 2.8) and waist circumference (adjusted mean difference −0.3, 95% CI −1.6 to 1.1). In posthoc analyses, neither infant nor childhood sleep duration were associated with anthropometric outcomes.

Conclusions A brief infant sleep intervention did not reduce overweight/obesity at 6 years. Population-based primary care sleep services seem unlikely to reduce the early childhood obesity epidemic.

Trial registration ISRCTN48752250

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  • Funding The Infant Sleep Study was funded by the Australian National Health and Medical Research Council (NHMRC) Project Grant 237120 and the Pratt Foundation, and the follow-up Kids Sleep Study by the Foundation for Children (Project Grant 180 2009). The authors' work was independent of the funders (the funding source had no involvement). MW was supported by NHMRC Population Health Career Development Awards #284556 and #546405, AP by a Melbourne Research Scholarship (The University of Melbourne), SC by the Foundation for Children Grant, and OCU's and HH's postdoctoral positions by NHMRC Population Health Capacity Building Grant 436914.

  • Competing interests None.

  • Ethical approval Project approval was obtained from Human Research Ethics Committee of The Royal Children's Hospital, Melbourne, for the Infant Sleep Study (23067B) and 6 year Kids Sleep Study follow-up (28137F).

  • Provenance and peer review Not commissioned; externally peer reviewed.