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正在上升的流行病，主要归因于超重和肥胖的惊人增长。人们认为，当前肥胖的流行主要是由环境因素驱动的，这些因素改变了能量摄入和能量消耗之间的平衡。众所周知，通过适度改变生活方式，减少热量摄入、改善食物选择和增加体育活动，预防糖尿病和肥胖是可以实现的目标。尽管为实施这种生活方式干预措施投入了大量资源，但糖尿病和肥胖造成的经济和公共卫生负担仍然巨大。因此，确定这种努力取得成功的潜在障碍和制定预防或治疗糖尿病和肥胖症的新战略是重大的公共卫生挑战。随着糖尿病和肥胖症的流行，自愿减少睡眠已经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时间的人的睡眠时间的干预措施是否有效

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.