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Sleep improvement seen in patients with greater weight loss
CHICAGO — Losing 5% or more of one’s initial body weight improved sleep duration and quality, at least in the short-term, according to a presenter at the joint meeting of the International Congress of Endocrinology and the Endocrine Society.
“Losing 5% or more of initial weight is associated with significant short-term improvements in sleep duration and quality. The improvements that we saw in mood following weight loss are consistent with previously reports in the Look AHEAD trial and the DPP trial,” Nasreen Alfaris, MD, MPH, from the University of Pennsylvania in Philadelphia, said during a presentation. “At month 24, baseline sleep duration of 7 to 8 hours was optimal and associated with significantly greater weight loss than baseline sleep duration more than 8 hours.”
The 2-year randomized trial, referred to as POWER-UP, focused on 390 participants (median age, 51.5 years; mean BMI, 38.5 kg/m2; 75.4% female) who underwent behavioral weight loss interventions in a primary care setting.
The behavioral randomization consisted of usual care, brief lifestyle counseling with monthly life coach visit or enhanced brief lifestyle counseling with meal replacement or medical intervention with a weight loss drug (orlistat or sibutramine). All participants had the aim of achieving a 1200-1800 kcal/day diet, 180 min/week activity and were given a pedometer, a calorie counting book, and handouts from Aim for a Healthy Weight, published by the National Heart, Lung, and Blood Institute.
At 6 months, all three groups lost weight: 2.0±0.5 kg in the usual care group; 3.5±0.5 kg in the brief counseling group; and 6.6±0.5 kg in the enhanced counseling group (P<0.5 for difference). The sleep and mood ratings improved in all groups, but there were not significant differences between the groups’ changes.
When reevaluated at 24 months, participants in the enhanced counseling group lost more weight than those under usual care (–4.6±0.7 vs. –2.0±0.5 kg; P<.05) and reflected similar improvements in sleep duration (13.8±9.0 vs. –9.0±9.0 min; P<.05). Both groups showed improvement in the PSQI and PHQ-8 ratings (P<.05), but there was no significant between-group difference.
The data showed that no matter the treatment plan, at 6 months, those that lost 5% or more of their weight increased their sleep duration by 21.6±7.2 min vs. those that lost less than 5% of their initial weight who only increased their duration by 1.6±0.6 minutes (P<.05). In the same pattern, improvements were seen in PSQI (–1.6±0.2 vs. –0.4±0.2; P<.001) and PHQ (–2.5±0.4 vs.–0.1±0.3; P<.0001) scores at 6 months. The only difference that remained significant at 24 months was that of the PHQ score (P<.05).
In comparing the amount of sleep participants reported, the group that reported 7-8 hours of sleep did lose 4.5 kg, a significantly higher amount as compared to the group that reported more than 8 hours of sleep (P<.05). Upon questions as to this reason, Alfaris said there are theories that those that sleep more than 8 hours at night are spending more overall time in bed and have less net activity, or that because these people are obese with increased pro-inflammatory cytokines which may promote sleep.
Alfaris said, “Further studies are needed of the possible effect of weight regain that happened in the POWER-UP that may play a role in mitigating the short-term improvements that we saw in our study of weight loss and sleep duration and sleep quality.”
For More Information: Alfaris N. Abstract OR07-01. Presented at: The joint meeting of the International Congress of Endocrinology and the Endocrine Society; June 21-24, 2014; Chicago.
Disclosures: Alfaris reported no relevant financial relationships.