Sleep extension reduced objectively assessed energy intake in a randomized clinical trial

A pattern of sleeping was highly relevant for the society over the past several decades. For example, one-third of the US population reported not getting the recommended 7 to 9 hours of sleep per night. Substantial evidence suggests that sleeping less than 7 hours per night on a regular basis is associated with adverse health consequences. In particular, insufficient sleep duration has been increasingly recognized as an important risk factor for weight gain and subsequent obesity. However, it remains unknown whether any strategies aiming at extending sleep duration can be effective for preventing or reversing obesity. The first randomized clinical trial supporting this hypothesis was published in JAMA Internal Medicine on February 7, 2022.

This single-center, randomized clinical trial enrolled adults aged 21 to 40 years with a body mass index between 25.0 and 29.9 kg/m2 and a habitual sleep duration of less than 6.5 hours per night. After 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 (sleep extension group) or to continue their habitual sleep (control group) for the next 2 weeks. All participants were instructed to continue daily routine activities at home without any prescribed diet or physical activity. The primary outcome was change in energy intake from baseline, which was objectively assessed as the sum of total energy expenditure and change in body energy stores. Total energy expenditure was measured by the doubly labeled water method. Change in body energy stores was computed using regression of daily home weights and body composition changes from dual-energy x-ray absorptiometry. Sleep duration was monitored by actigraphy. Changes from baseline were compared between the 2 groups using intention-to-treat analysis.

Data from 80 randomized participants (mean [SD] age, 29.8 [5.1] years; 41 men [51.3%]) were analyzed. 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 vs the control group. 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). No significant treatment effect in total energy expenditure was found, resulting in weight reduction in the sleep extension group vs the control group (−0.87 kg; 95% CI, −1.39 to −0.35 kg; P = .001).



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