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

描述（由研究者提供）：肥胖流行病的上升是一个高度优先的公共卫生问题。减肥主要是通过负能量平衡来实现的-更少的卡路里“进”，更多的卡路里“出”。然而，在那些超重或肥胖的人中，简单地尝试“少吃多运动”的努力往往会导致令人失望的结果。一个可能阻碍减肥的潜在影响因素是睡眠不足，至少有25%的美国成年人经历过睡眠不足，通过最近的流行病学研究和机械可接受性证据，睡眠不足与体重增加和肥胖密切相关。目的：长期目标是研究当添加到饮食和运动的传统减肥方法中时，睡眠量和/或质量的改善是否会增加成功的减肥和减肥维持。近期目标是进行初步试点研究。目标人群：超重或肥胖的失眠成年人可能对标准化的、睡眠特异性的认知行为疗法有反应。产品设计：为期8个月的试点干预将涉及将30名超重/肥胖成年人随机分配到两个治疗组之一：1）标准饮食和体力活动加睡眠改善（D+PA+S），或2）标准饮食和体力活动加注意力控制计划（D+PA+AC）。两组都将接受相同的干预措施，以减少饮食能量摄入和增加体力活动。D+PA+S组将接受基于认知行为疗法的额外指导课程，以改善睡眠习惯。D+PA+AC组将接受相同数量的额外教学课程，主题不太可能有助于减肥成功，除了主要的D+PA成分（例如，全球变暖）。结果：这一发展和试点项目将解决重要的可行性问题，并产生与招募、保留有关的试点数据，以及对睡眠、饮食、体育活动、饥饿/饱腹感和体重影响的初步结果。影响：如果在减肥计划中添加睡眠改善成分可以增加成功减肥和减肥维持，那么这种策略可以帮助目前超重或肥胖的2/3美国人口的大部分。由于睡眠不足的认知行为疗法是标准化的，并且广泛可用，这些研究结果将适合广泛传播。公共卫生相关性：在美国，肥胖和睡眠障碍的发病率都在上升。这项研究的主要目的是研究在传统的“饮食和运动”方法中加入睡眠改善成分的效果，以确定这是否能有效帮助患有慢性睡眠障碍的超重和/或肥胖成年人改善他们的减肥成功率。

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.