Extending Sleep in Obese Adults to Promote Weight Loss

描述（由研究者提供）：美国大约三分之二的成年人超重或肥胖。没有一个人口群体能幸免；所有年龄组、男女和所有种族的肥胖率都有上升的记录。肥胖人数急剧增加的原因包括久坐不动的生活方式越来越多，食品生产和营销方式的变化，中央供暖和空调的使用越来越多，怀孕年龄的增加，吸烟率的下降以及睡眠时间的减少。由于自愿减少睡眠而导致的睡眠不足在各个年龄段的美国人中都很常见。大量的流行病学研究揭示了睡眠时间减少和体重指数（BMI）增加之间的剂量依赖关系。此外，控制良好的实验室研究已经证明，睡眠不足似乎通过改变代谢激素准确发出热量需求信号的能力来上调食欲，改变葡萄糖代谢，增加胰岛素抵抗，并升高血压。有人提出延长睡眠时间有助于减肥，但从未经过验证。因此，该项目的目标是为未来的临床试验奠定基础，以验证每晚至少睡眠7.5小时的健康肥胖者比每晚睡眠6.5小时的健康肥胖者减轻的体重更多。具体来说，该项目的目标包括：1)延长睡眠时间方案作为传统减肥方案的辅助方案的可行性测试；2)比较延长睡眠时间结合热量限制和运动与传统的热量限制和运动控制体重方案对肥胖个体减肥的效果；3)比较睡眠延长方案结合热量限制和运动与由热量限制和运动组成的传统减肥计划和由热量限制和运动组成的传统减肥计划对健康肥胖个体血糖水平和血压正常化的效果；4)探讨延长睡眠时间对瘦素和胃饥饿素水平的影响。睡眠延长方案将利用与天普大学肥胖研究与教育中心已经使用的行为改变方案相同的原则，例如，在行为上进行渐进但可持续的改变，设定每周行为目标，自我监控目标进展，识别障碍等，并将纳入每周小组会议。公共卫生相关性：据估计，美国大约三分之二的成年人超重或肥胖。由于即使是适度的超重也与发病率和死亡率增加有关，因此需要采取额外的战略来防治日益严重的肥胖流行病。这项研究是确定延长睡眠时间是否有助于个人减肥的第一步。

DESCRIPTION (provided by investigator): Approximately two-thirds of all adults in the United States are estimated to be overweight or obese. No demographic group has been spared; increased rates of obesity have been documented in all age groups, in both sexes, and among all ethnic groups. Explanations for the dramatic increase in obesity include increasingly sedentary lifestyles, and changes in food manufacturing and marketing practices, the increased use of central heating and air conditioning, increasing gravid age, decreased smoking rates, and decreased sleep durations. Sleep loss due to voluntary curtailment of sleep is common among Americans of all ages. Numerous epidemiologic studies have revealed a dose-dependant relationship between reduced sleep duration and increased body mass index (BMI). In addition, well-controlled laboratory studies have documented that sleep loss appears to up-regulate appetite by altering the ability of metabolic hormones to accurately signal caloric need, alters glucose metabolism and increases insulin resistance, and elevates blood pressure. It has been suggested--but never tested--that extending sleep will facilitate weight loss. Therefore, the goal is of this project is to lay the groundwork for a future clinical trial testing the hypothesis that healthy obese individuals who obtain at least 7.5 hours sleep per night will loose more weight than healthy obese adults obtaining 6.5 hours sleep per night. Specifically, the goals of this project include: 1) feasibility testing of a sleep extension protocol as an adjuvant to traditional weight loss programs; 2) comparing the efficacy of sleep extension in combination with caloric restriction and exercise to a traditional weight control program consisting of caloric restriction and exercise for facilitating weight loss in obese individuals; 3) comparing the efficacy of a sleep extension protocol in combination with caloric restriction and exercise to a traditional weight loss program consisting of caloric restriction and exercise to a traditional weight loss program consisting of caloric restriction and exercise for normalizing glucose levels and blood pressure in healthy obese individuals; and 4) explore the effect of sleep extension on leptin and ghrelin levels. The sleep extension protocol will utilize the same principles as the behavioral modification protocol already in use at Temple University's Center for Obesity Research and Education e.g., making incremental but sustainable changes in behavior, setting weekly behavioral goals, self-monitoring of progress towards goals, identification of barriers, etc., and will be incorporated into weekly group meetings. PUBLIC HEALTH RELEVANCE: Approximately two-thirds of all adults in the United States are estimated to be overweight or obese. Since even moderate amounts of excess weight are associated with increased morbidity and mortality, additional strategies are needed to combat the growing obesity epidemic. This study represents a beginning step in determining if extending sleep would assist individuals in loosing weight.