Sleep Extension: A Potential Target for Obesity Treatment
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OBESITY (KM GADDE AND P SINGH, SECTION EDITORS)
Sleep Extension: A Potential Target for Obesity Treatment Kristin K. Hoddy 1 & Kaitlin S. Potts 2 & Lydia A. Bazzano 2 & John P. Kirwan 1 Accepted: 26 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Sleep and obesity share a bidirectional relationship, and weight loss has been shown to enhance sleep. Aiming to extend sleep on its own or as part of a lifestyle intervention may attenuate health consequences of short sleep. This review highlights several sleep extension approaches, discusses feasibility of each, and summarizes findings relevant to obesity. Recent Findings Sleep extension in response to experimental sleep restriction demonstrates partial rescue of cardiometabolic dysfunction in some but not all studies. Adequate sleep on a nightly basis may be necessary for optimal health. While initial sleep extension interventions in habitually short sleepers have been met with obstacles, preliminary findings suggest that sleep extension or sleep hygiene interventions may improve glycemic control, decrease blood pressure, and enhance weight loss. Summary Sleep extension has the potential to attenuate obesity risk and cardiometabolic dysfunction. There is tremendous opportunity for future research that establishes a minimum threshold for sleep extension effectiveness and addresses logistical barriers identified in seminal studies. Keywords Insulin sensitivity . Blood pressure . Sleep recovery . Sleep extension . Catch-up sleep . Sleep hygiene
Introduction Short sleep duration constitutes a strong relationship with obesity and affects a large proportion of adults [1, 2]. Experts recommend at least 7 h of nightly sleep [3]. Yet, 35% of US adults consistently fall short of this target [2] and an overwhelming majority (~ 70%) report sleep deficits occurring monthly [4]. Short sleeping adults are 55% more likely to have obesity [5, 6], are more susceptible to weight gain over time [7, 8], and appear to accumulate greater visceral and ectopic fat [9]. Causation cannot be determine from observations alone and limited experimental studies make it difficult to ascertain whether sleep restriction specifically causes weight gain [10•, 11•]. Despite this controversy, a collection of shortterm experimental studies (< 2 weeks) align with the concept This article is part of the Topical Collection on Obesity * Kristin K. Hoddy [email protected] 1
Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA
2
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
that insufficient sleep enhances obesity risk [11•, 12•]. Excessive energy intake is a likely cause [11•, 12•, 13] with heightened hunger [11•], hormonal and neurological responses [11•, 14•, 15], and eating later in the day [16, 17] offering potential mechanisms that serve to further increase risk. Insufficient sleep is also associated with obesity co-morbidities, such
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