Impact of Sleep Extension on Insulin Sensitivity and Dietary Intake in Adolescents

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PROJECT SUMMARY Today’s adolescents habitually obtain well below the recommended 8-10 hours of sleep per night. Insufficient sleep is associated with increased risk of obesity, insulin resistance, and dietary changes and may be contributing to the recent sharp increases in pediatric obesity and type 2 diabetes (T2D). Sleep is therefore a potential novel target for obesity and T2D prevention. However, it is yet unclear whether interventions to extend sleep duration can improve insulin sensitivity and circadian timing of dietary intake, and we lack understanding of sleep health perceptions of adolescents with obesity and T2D. With this career development award, I propose to examine the effect of increased sleep duration on insulin sensitivity and dietary intake in typically short-sleeping adolescents and qualitatively assess sleep perceptions in youth with obesity and T2D. Candidate and Mentors: I am an Assistant Professor of Pediatrics at the University of Colorado and Children’s Hospital Colorado where I am a clinical sleep psychologist focused on research to prevent diabetes and diabetes complications. I completed a research fellowship focused on the effect of sleep restriction on dietary intake, and obtained pilot funding to examine sleep and insulin sensitivity in adolescents with obesity. I have built strong relationships with my mentorship team, which includes co-mentors Dr. Kristen Nadeau (pediatric endocrinology, obesity and diabetes), and Dr. Kenneth Wright (adult sleep health), who will oversee the proposed training and research. Research and Training: I propose short-term scientific, educational, and training goals that can be ideally met with a mentored research award. I will build upon my prior research with three research aims: examine the effect of extending sleep on 1) insulin sensitivity/secretion and 2) circadian timing of dietary intake among adolescents with habitually insufficient sleep, and 3) identify key perceptions, barriers, and facilitators to obtaining sufficient sleep in adolescents with obesity and T2D, to inform the refinement of a sleep extension manipulation in this at-risk population. Complementary training aims include: 1) IVGTT performance and modelling; 2) circadian rhythms; 3) advanced energy intake/expenditure assessment; and 4) qualitative methodology. At award completion, I will have the skills to be a successful independent investigator and will pursue funding to tailor a sleep intervention across the spectrum of metabolic disease aimed at understanding mechanisms in the relationship between sleep, circadian rhythms, and T2D in adolescents. Summary: Sleep is a novel target in the prevention and treatment of obesity and T2D in adolescents. My overall career goal is to develop interventions to improve sleep health in adolescents with a specific goal of preventing progression of sleep-related endocrine and metabolic dysfunction as known precursors to obesity and T2D. Completion of this career development award will support my development into an independent clinical translational investigator and expert scientist in adolescent sleep and metabolism research.