Sleep Extension To Reduce Diabetes and Obesity Risk

描述（由申请人提供）：糖尿病在美国是一种不断上升的流行病，这在很大程度上归因于超重和肥胖的惊人增长。据信，目前肥胖症的流行主要是由改变能量摄入和能量消耗之间的平衡的环境因素驱动的。人们普遍认识到，通过适当改变生活方式，减少热量摄入、改善食物选择和增加体育活动，预防糖尿病和肥胖症是一个可以实现的目标。尽管为实施这种生活方式干预措施投入了大量资源，但糖尿病和肥胖症的经济和公共卫生负担仍然巨大。因此，识别这种努力取得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策略是关键的公共卫生挑战。随着糖尿病和肥胖症的流行，自愿睡眠缩短已成为一种越来越普遍的行为。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风险的重要调节因素。然而，目前尚不清楚旨在增加习惯性减少睡眠的人的睡眠时间的干预措施是否具有 对能量代谢的任何有益影响。因此，我们的总体目标是在真实的生活环境中进行干预研究，以调查睡眠延长对习惯性短睡眠者葡萄糖代谢和能量平衡的影响。我们提出了一项随机对照研究，将联合收割机在自由生活条件下对睡眠的客观监测与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的最先进方法相结合。将研究习惯性每晚睡眠少于6小时的超重年轻人（经腕动记录仪证实）。在2周习惯性睡眠[基线]期后，受试者将被随机分配至2周睡眠延长组（延长组，n=40）或2周持续习惯性睡眠组（对照组，n=40）。我们将在每个2周的睡眠期间执行相同的程序，并比较两组之间相对于基线的变化。我们的具体目标是测试以下假设：1）睡眠延长将改善胰岛素敏感性和β细胞功能; 2）睡眠延长将减少平均每日能量摄入; 3）睡眠延长将增加每日总能量消耗，主要是由于体力活动的增加。本研究 将是第一个研究旨在延长睡眠时间的干预措施如何影响糖尿病和肥胖风险个体在真实的生活环境中的葡萄糖代谢、能量摄入和能量消耗的人。这些发现可能为我们理解睡眠和能量代谢之间联系的过程提供重要见解。如果这项研究表明睡眠延长对能量代谢有明显的好处，那么这些发现可能对开发新的生活方式策略具有重要意义，这些策略旨在减轻目前肥胖和2型糖尿病流行的负担，从而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.