Sleep Extension To Reduce Diabetes and Obesity Risk

描述(申请人提供)：糖尿病在美国是一种日益流行的疾病，很大程度上是由于超重和肥胖的惊人增长。人们认为，目前肥胖的流行主要是由改变能量摄入和能量消耗平衡的环境因素推动的。众所周知，预防糖尿病和肥胖是一个可以通过适度改变生活方式来实现的目标，目的是减少卡路里摄入量、改善食物选择和增加体力活动。尽管大量资源用于实施这种生活方式干预措施，但糖尿病和肥胖症造成的经济和公共卫生负担仍然巨大。因此，在这种努力中找出成功的潜在障碍，以及开发预防或治疗糖尿病和肥胖症的新战略，是关键的公共卫生挑战。随着糖尿病和肥胖症的流行，自愿减少睡眠已成为一种日益普遍的行为。来自流行病学和实验室研究的大量证据表明，睡眠时间短可能是糖尿病和肥胖症风险的重要调节因素。然而，目前仍不清楚旨在延长习惯性减少睡眠的人的睡眠时间的干预措施是否起到了作用 对能量代谢有任何有益的影响。因此，我们的总体目标是在现实生活环境中进行一项干预研究，以调查睡眠时间延长对习惯性短睡眠者糖代谢和能量平衡的影响。我们提出了一项随机对照研究，将结合对自由生活条件下的睡眠进行客观监测，并采用最先进的方法评估胰岛素敏感性和β细胞功能、身体成分、能量摄入和食物偏好，以及能量消耗的所有组成部分。那些习惯每晚睡眠时间少于6小时的超重年轻人将被纳入研究范围。在2周的习惯性睡眠[基线]阶段之后，受试者将被随机分为延长睡眠2周(延长组，n=40)或继续习惯性睡眠2周(控制组，n=40)。我们将在每两周的睡眠期间执行相同的程序，并将比较两组之间与基线的变化。我们的具体目标是检验以下假设：1)延长睡眠时间将改善胰岛素敏感性和β细胞功能；2)延长睡眠时间将减少平均每日能量摄入量；3)延长睡眠时间将增加每日总能量消耗，这主要是由于体力活动的增加。本研究 将首次研究旨在延长睡眠时间的干预措施如何影响现实生活中有糖尿病和肥胖风险的个人的葡萄糖代谢、能量摄入和能量消耗。这些发现可能会为我们理解睡眠和能量代谢之间潜在的过程提供重要的见解。如果这项拟议的研究表明，延长睡眠时间对能量代谢有明显好处，这些发现可能会对开发新的生活方式策略产生重要影响，这些策略旨在减轻当前流行的肥胖症和2型糖尿病的负担，从而可能使数百万美国人受益。

DESCRIPTION (provided by applicant): Diabetes is a rising epidemic in the U.S., largely attributed to the alarming increase in overweight and obesity. It is believed that the current epidemic of obesity is mainly driven by environmental factors that alter the balance between energy intake and energy expenditure. It is well recognized that the prevention of diabetes and obesity is an attainable goal through modest lifestyle changes aimed at reducing caloric intake, improving food choices and increasing physical activity. Despite substantial resources applied to implement such lifestyle interventions, the economic and public health burden of diabetes and obesity remains enormous. Thus, the identification of potential barriers to success in such effort and the development of novel strategies to prevent or treat diabetes and obesity are critical public health challenges. In parallel with the epidemics of diabetes and obesity, voluntary sleep curtailment has become an increasingly prevalent behavior. Substantial evidence from epidemiologic and laboratory studies suggest that short sleep duration may be an important modulator of diabetes and obesity risk. However, it remains unknown today whether an intervention aimed to increase sleep duration in individuals who habitually curtail their sleep has any beneficial effects on energy metabolism. Our overall goal is therefore to conduct an intervention study in a real life setting to investigate the effects of sleep extension on glucose metabolism and energy balance in habitual short sleepers. We propose a randomized controlled study that will combine objective monitoring of sleep in free-living conditions with the state-of-the-art methods for assessments of insulin sensitivity and beta cell function, body composition, energy intake and food preferences, and all components of energy expenditure. Overweight young adults who habitually sleep less than 6 hours per night (as confirmed by actigraphy) will be studied. After 2-weeks of habitual sleep [baseline] period, subjects will be randomized to either 2-weeks of sleep extension (Extension group, n=40) or 2-weeks of continued habitual sleep (Control group, n=40). We will perform the same procedures during each 2-week sleep period and changes from baseline will be compared between the 2 groups. Our specific aims are to test the hypotheses that: 1) sleep extension will improve insulin sensitivity and beta cell function; 2) sleep extension will reduce average daily energy intake; 3) sleep extension will increase total daily energy expenditure, mainly due to an increase in physical activity. This study will be the first to examine how an intervention aimed to extend sleep duration affects glucose metabolism, energy intake and energy expenditure in a real life setting in individuals who are at risk for diabetes and obesity. These findings may provide important insights to our understanding of the processes underlying the links between sleep and energy metabolism. If the proposed study demonstrates a clear benefit of sleep extension on energy metabolism, these findings may have important implications for the development of novel lifestyle strategies aimed to reduce the burden of current epidemics of obesity and type 2 diabetes, and thus may benefit millions of Americans.