Sleep Extension Reduces Energy Intake in Overweight Adults

Esra Tasali, MD

A new investigation from Chicago found that sleep extension reduced energy intake and resulted in a negative energy balance in real-life settings among overweight adults who routinely curtailed their sleep duration.

Investigators suggested that improving and maintaining healthy sleep duration over longer time periods could be practiced in obesity prevention and weight loss programs.

Previous studies had recognized sleep duration as a risk factor for obesity, though the mitigation of the risk of obesity through extending sleep duration remains unknown.

As such, investigators led by Esra Tasali, MD, Department of Medicine at the University of Chicago, set out to determine the effects of sleep extension intervention on objectively assessed energy intake, energy expenditure, and body weight in real-life settings among adults with overweight who habitually curtailed their sleep duration.

The Methods

Tasali and colleagues conducted a single-center, parallel-group, randomized clinical trial from November 1, 2014, to October 30, 2020.

Adults men and women aged 21 to 40 years with a BMI between 25.0 and 29.9 and a mean habitual sleep duration of less than 6.5 hours per night were eligible for the trial. All participants were required to have stable self-reported sleep habits for the past 6 months.

Participants were recruited from the local community and were tasked with completing an initial online survey followed by a face-to-face interview. Race and ethnicity data were self-reported and included Asian, Black or African American, Hispanic, and White categories.

From there, all participants underwent a laboratory screening to determine eligibility. Habitual sleep duration was confirmed by a 1-week screening wrist actigraphy at home.

Following a 2-week habitual sleep period at baseline, participants were randomized to either an individualized sleep hygiene counseling session that was intended to extend their bedtime to 8.5 hours (the sleep extension group) or to continue their habitual sleep.

All participants were instructed to continue daily routine activities at home without any prescribed diet or physical activity.

The Findings

A total of 80 randomized participants were included in the study. Participants had a mean age of 28.9 (5.1) years and consisted of 41 men (51.3%) and 39 women (48.7%).

Investigators observed that participants in the sleep extension group had a significant increase from baseline in mean sleep duration by actigraphy compared with those in the control group (1.2 hours; 95% CI, 1.0- 1.4 hours; P < .001). The findings were similar regarding change in sleep duration when only participants' workdays (1.3 hours; 95% CI, 1.0-1.5 hours; P < .001) or free days (1.1 hours; 95% CI, 0.7-1.5 hours; P < .001) were considered.

Additionally, sleep duration was increased by approximately 1.2 hours per night (95% CI, 1.0 to 1.4 hours; P < .001) in the sleep extension group compared with the control group, and the sleep extension group had a significant decrease in energy intake compared with the control group (−270 kcal/d; 95% CI, −393 to −147 kcal/d; P < .001).

The change in sleep duration was inversely correlated with the change in energy intake (r = −0.41; 95% CI, −0.59 to −0.20; P < .001). However, no significant treatment effect in total energy expenditure was found, resulting in weight reduction in the sleep extension group vs the control group.

Overall, the trial found that short-term sleep extension reduced objectively measured intake and resulted in a negative energy balance in real-life settings in overweight adults.

“The findings highlighted the importance of improving and maintaining adequate sleep duration as a public health target for obesity prevention and increasing awareness about the benefits of adequate sleep duration for healthy weight maintenance,” the team wrote.