Sleep Deprivation and Energy Balance
Condition: Obesity
MeSH terms: Sleep Deprivation
Study type: Interventional

Summary: 
      Observational and epidemiological studies have found a link between obesity and short sleep
      duration with the prevalence of both increasing in the past decades. At this time, it is
      unknown whether short sleep is a cause of obesity and how short sleep would lead to obesity.
      Some studies associate short sleep with increased levels of hormone that stimulate appetite.
      This study will examine how food intake and energy expenditure can be modified by sleep
      duration as a means of understanding a potential causal pathway.
    

Detailed description: 
      Recent epidemiological studies show that short sleep duration (≤5-7 h/night) correlates with
      overweight and obesity, such that individuals with short sleep periods tend to have a higher
      body mass index (BMI) than those who sleep 8-9 h/night. The mechanism for this relationship
      is currently unknown. However, energy balance must be disrupted to produce weight gain.
      Therefore, the purpose of this study is to examine the impact of short sleep duration, 4
      h/night, relative to habitual sleep duration of 8-9 h/night, on energy balance. The major
      aims of this study are to compare energy expenditure and energy intake during the periods of
      habitual and short sleep duration and to examine the neural and hormonal pathways involved in
      eating behavior under periods of habitual and short sleep. Men and women, 30-45 y and BMI
      22-25 kg/m2, will be recruited to participate in this randomized, crossover study of short
      and habitual sleep periods. During each period of 5 nights, subjects will be required to
      sleep at the laboratory under supervision. During this time, subjects will be total
      inpatients to ensure compliance with the protocol. Each sleep duration period will be
      separated by a 2-4-wk washout period. On the first day of each phase, subjects will be given
      a dose of doubly-labeled water to measure free-living energy expenditure over the 6-d period.
      During the first 4 days, energy intake will be controlled and meals served at fixed times.
      The last 2 days will be ad libitum feeding of self-selected meals. Hormones, including
      leptin, insulin, ghrelin, PYY, adiponectin, and GLP-1 will be assessed daily in the fasted
      state and, on day 4, over a 24-hour period, while subjects are consuming a controlled diet
      with fixed meal times. Functional magnetic resonance imaging measurements of brain activity
      in response to food stimuli will be done on day 5 to examine brain regions associated with
      motivation to eat. On day 5, subjects will undergo measurements of basal metabolic rate using
      indirect calorimetry. Ad libitum energy intakes will be assessed on days 5 and 6.
      Polysomnographic monitoring will be performed nightly to assess sleep duration. Mediation
      analyses will allow us to determine whether hormone levels are related to and predictive of
      energy expenditure and energy intake data. The measurements performed in this study will
      allow us to determine how reduced sleep periods can impact energy balance and potentially
      lead to changes in body weight. As such, it will provide comprehensive information of the
      neural, physiological, hormonal, and behavioral networks related to energy balance and which
      are affected by sleep duration.
    

Intervention name(s): Sleep
Intervention type(s): Behavioral
Intervention description(s): Subjects are randomly assigned to one of 2 arms sequence: short followed by regular or regular followed by short. Each arm is 6 days in length and separated by a 2-4 week washout period.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Energy balance; Weight management; Food intake; Energy expenditure