Adding Sleep Intervention to Traditional Exercise & Diet Approach to Weight Loss

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DESCRIPTION (provided by investigator): The rising obesity epidemic is a high priority public health issue. Weight loss is primarily achieved through a negative energy balance - fewer calories "in," more calories "out." However, among those who are overweight or obese, efforts to simply try to "eat less and exercise more" often lead to disappointing results. A potentially influential factor that may hinder weight loss is inadequate sleep, which is experienced by at least 25 percent of US adults and has now been strongly linked to weight gain and obesity through both recent epidemiological studies and evidence of mechanistic plausibility. OBJECTIVE: The long-term objective is to study whether improvement in sleep quantity and/or quality will increase successful weight loss and weight loss maintenance when added to a traditional weight loss approach of diet and exercise. The immediate objective is to conduct a preliminary pilot study. TARGET POPULATION: Overweight or obese adults with insomnia that are likely to be responsive to a standardized, sleep-specific, cognitive behavioral therapy. DESIGN: The 8-month pilot intervention will involve random assignment of 30 overweight/obese adults to one of two treatment groups: 1) Standard Diet and Physical Activity plus Sleep Improvement (D+PA+S), or 2) Standard Diet and Physical Activity plus an Attention Control program (D+PA+AC). Both groups will receive identical interventions for reducing dietary energy intake and increasing physical activity. The D+PA+S group will receive additional instructional sessions based on cognitive behavioral therapy for improving sleep habits. The D+PA+AC group will receive an identical number of additional instructional sessions on topics unlikely to contribute to weight loss success beyond the primary D+PA component (e.g., global warming). OUTCOMES: This developmental and pilot project will address important feasibility issues, and generate pilot data related to recruitment, retention, and preliminary results of effects on sleep, diet, physical activity, hunger/satiety and weight. IMPLICATIONS: If the addition of a sleep improvement component to a weight loss program increases successful weight loss and weight loss maintenance, this strategy could help a substantial proportion of the 2/3 of the US population that is currently overweight or obese. Since cognitive behavioral therapy for inadequate sleep is standardized and widely available these research results would be amenable to broad dissemination. PUBLIC HEALTH RELEVANCE: The rates of both obesity and sleep disorders are on the rise in the U.S. The major purpose of this study is to examine the effects of adding a sleep-improvement component to a traditional approach of "diet and exercise" to determine if this would be effective in helping overweight and/or obese adults who suffer from chronic sleep disturbances to improve their success with weight loss.