Research
Review
Partial Sleep Deprivation and Energy Balance in Adults: An Emerging Issue for Consideration by Dietetics Practitioners

https://doi.org/10.1016/j.jand.2012.07.032Get rights and content

Abstract

During the past 30 years, rates of partial sleep deprivation and obesity have increased in the United States. Evidence linking partial sleep deprivation, defined as sleeping <6 hours per night, to energy imbalance is relevant to weight gain prevention and weight loss promotion. With a majority of Americans overweight or obese, weight loss is a recommended strategy for reducing comorbid conditions. Our purpose was to review the literature regarding the role of partial sleep deprivation on energy balance and weight regulation. An inverse relationship between obesity and sleep duration has been demonstrated in cross-sectional and prospective studies. Several intervention studies have tested mechanisms by which partial sleep deprivation affects energy balance. Reduced sleep may disrupt appetitive hormone regulation, specifically increasing ghrelin and decreasing leptin and, thereby, influence energy intake. Increased wakefulness also may promote food intake episodes and energy imbalance. Energy expenditure may not be greatly affected by partial sleep deprivation, although additional and more accurate methods of measurements may be necessary to detect subtle changes in energy expenditure. Body weight loss achieved by reduced energy intake and/or increased energy expenditure combined with partial sleep deprivation may contribute to undesirable body composition change with proportionately more fat-free soft tissue mass lost compared with fat mass. Evaluating sleep patterns and recommending regular, sufficient sleep for individuals striving to manage weight may be prudent.

Section snippets

Methods

A search was conducted for articles examining partial sleep deprivation using the operational definition of nightly sleep lasting between 4 and 6 hours,34 excluding clinical sleep conditions, such as obstructive sleep apnea.35 Original articles published between 1996 and October 2011 were collected with a PubMed search restricted to articles conducted in adult human beings and published in English. The medical subject heading terms sleep deprivation (or insufficient sleep, reduced sleep, short

Results

Due to the nature of randomized sleep trials, sample sizes were small, usually with ≤20 participants per investigation. Participants in 10 of the 18 studies were healthy, young, nonsmoking men who were free from disease.19, 20, 27, 37, 38, 39, 40, 41, 42, 43 Participants in five studies18, 44, 45, 46, 47 were healthy men and women. Two studies were in overweight or obese men and women,48, 49 and the remaining study was conducted in women who were healthy, overweight, or obese.50

Common

Discussion

Partial sleep deprivation has been linked to obesity and body weight gain; however, the role of sleep duration during weight loss and weight maintenance is unclear. The reviewed studies have examined potential mechanisms for an effect of partial sleep deprivation on energy balance. Population studies have reported increases in ghrelin and decreases in leptin during sleep deprivation consistent with increases in appetite.5, 56 Several studies in our review reported increases in ghrelin,42, 49

Clinical Implications

Caution should be taken when interpreting results of our review, due to the limited number of studies and small sample sizes of each study. Standardized techniques of reducing sleep have not been used, with some studies describing the centering of sleep to maintain circadian rhythm and other studies using anchored sleep and wake times. Measurement of body weight, energy intake, and energy expenditure, as well as hormonal factors, is imperative for examination of overall energy balance. Because

Future Research

Experiments and interventions to further broaden the understanding of the role of sufficient sleep in the prevention and treatment of obesity are needed. Examination of realistic sleep conditions and practical lifestyle modifications are vital. Many intervention studies apply experimental sleep conditions for ≤1 week, uncharacteristically brief even for those currently considered short sleepers. More applicable studies would incorporate extended durations of more realistic short sleep

Conclusions

Research to describe the effects of sleep deprivation on body composition is lacking, including studies describing alterations in substrate use. Examination of differences in protein turnover or nitrogen excretion during weight loss with partial sleep deprivation may be necessary to describe changes in body composition and substrate use. Further research to examine how partial sleep deprivation induces glucose intolerance and free fatty acid mobilization, as well as altered counter-regulatory

J. D. Shlisky is a research assistant, The Pennsylvania State University, University Park.

References (66)

  • W.D.S. Killgore et al.

    Sleep deprivation reduces perceived emotional intelligence and constructive thinking skills

    Sleep Med

    (2008)
  • K.M. Flegal et al.

    Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010

    JAMA

    (2012)
  • P.M. Krueger et al.

    Sleep duration in the United States: A cross-sectional population-based study

    Am J Epidemiol

    (2009)
  • S.R. Patel et al.

    Short sleep duration and weight gain: A systematic review

    Obesity (Silver Spring)

    (2008)
  • F.P. Cappuccio et al.

    Meta-analysis of short sleep duration and obesity in children and adults

    Sleep

    (2008)
  • S. Taheri et al.

    Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index

    PLoS Med

    (2004)
  • S.E. Luckhaupt et al.

    The prevalence of short sleep duration by industry and occupation in the National Health Interview Survey

    Sleep

    (2010)
  • Healthy People 2020

    (2010)
  • K.L. Knutson et al.

    Trends in the prevalence of short sleepers in the USA: 1975-2006

    Sleep

    (2010)
  • Effect of short sleep duration on daily activities—United States, 2005-2008

    MMWR Morbid Mortal Wkly Rep

    (2011)
  • T. Shochat et al.

    Sleep patterns, electronic media exposure and daytime sleep-related behaviours among Israeli adolescents

    Acta Paediatr

    (2010)
  • F.C. Baker et al.

    Association of sociodemographic, lifestyle, and health factors with sleep quality and daytime sleepiness in women: Findings from the 2007 National Sleep Foundation “Sleep in America Poll.”

    J Womens Health (Larchmt)

    (2009)
  • M. Garaulet et al.

    CLOCK gene is implicated in weight reduction in obese patients participating in a dietary programme based on the Mediterranean diet

    Int J Obes (Lond)

    (2010)
  • E.P. Gunderson et al.

    Association of fewer hours of sleep at 6 months postpartum with substantial weight retention at 1 year postpartum

    Am J Epidemiol

    (2008)
  • E.M. Taveras et al.

    Association of maternal short sleep duration with adiposity and cardiometabolic status at 3 years postpartum

    Obesity (Silver Spring)

    (2011)
  • C.R. Elder et al.

    Impact of sleep, screen time, depression and stress on weight change in the intensive weight loss phase of the LIFE study

    Int J Obes (Lond)

    (2012)
  • P. Lyytikäinen et al.

    Association of sleep duration with weight and weight gain: A prospective follow-up study

    J Sleep Res

    (2011)
  • M. Watanabe et al.

    Association of short sleep duration with weight gain and obesity at 1-year follow-up: A large-scale prospective study

    Sleep

    (2010)
  • J. Hall et al.

    Energy homoeostasis: The roles of adipose tissue-derived hormones, peptide YY and ghrelin

    Obes Facts

    (2009)
  • D.E. Cummings et al.

    Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery

    N Engl J Med

    (2002)
  • A. Mavri et al.

    Effect of diet-induced weight loss on endothelial dysfunction: Early improvement after the first week of dieting

    Heart Vessels

    (2011)
  • J.W. Kolaczynski et al.

    Response of leptin to short-term and prolonged overfeeding in humans

    J Clin Endocrinol Metab

    (1996)
  • K. Simpson et al.

    CCK, PYY and PP: The control of energy balance

    Handb Exp Pharmacol

    (2012)
  • Cited by (39)

    • Sleep problems and their association with weight and waist gain - The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

      2020, Sleep Medicine
      Citation Excerpt :

      Possible mechanisms linking inadequate sleep to higher risk of obesity have been proposed, among them poor eating habits, inadequate physical activity practices [19,34] and hormonal imbalances [35,36]. Individuals with inadequate sleep could have more opportunity to eat due to longer time spent awake [35] and a tendency to prefer more palatable and energy-dense foods (such as ultra-processed foods, fast foods) even in the absence of physiological hunger [37,36,38]. A cross-sectional study showed that energy-dense food intake close to bedtime (30–60 min before) was associated with poor sleep quality, including a longer time to fall asleep (sleep latency) [39].

    • Insomnia symptoms and sleep duration and their combined effects in relation to associations with obesity and central obesity

      2018, Sleep Medicine
      Citation Excerpt :

      However, conclusions about causal relationships are hampered by the cross-sectional design and the fact that the causal pathway for sleep duration or insomnia and obesity is still not entirely clear. Weight gain and obesity occur as a result of an imbalance between energy intake and energy expenditure and sleep has been identified as an underlying cause of changes in energy balance [42–44]. Moreover, there are data indicating that cortical hyperarousal is greatest in insomnia with short sleep duration [45].

    • Exploring the mediating role of energy balance-related behaviours in the association between sleep duration and obesity in European adults. The SPOTLIGHT project

      2017, Preventive Medicine
      Citation Excerpt :

      For leisure time- and transport-related physical activity we found significant negative associations between physical activity and obesity in the total sample, middle and oldest age group, as found in other studies (Stamatakis et al., 2009; Pate et al., 2015). We found no association between sleep duration and physical activity in any of the age groups, corresponding to the findings of a systematic review (Shlisky et al., 2012). It was found that the relation between sleep duration and physical activity varies between individuals (Klingenberg et al., 2012), that is, some people show lower levels of physical activity after sleep restriction, some higher levels and some did not change at all (Klingenberg et al., 2012).

    • Psychiatric co-morbidity in women presenting across the continuum of disordered eating

      2014, Eating Behaviors
      Citation Excerpt :

      In general, the hormones are key to signaling 1) when the body needs fuel (ghrelin is released and stimulates a hunger response) and 2) when the body is satiated (adequate concentration of leptin circulates through the body and signals satiety). Interestingly, many studies have shown that when an individual is sleep deprived the concentration of leptin decreases and ghrelin increases leading to increased appetite (Calvin et al., 2013; Copinschi, Leproult, & Spiegel, 2014; Shlisky et al., 2012). Indeed, studies have found that individuals who are sleep deprived show an increase in appetite and desire for calorically dense foods (Spiegel, Tasali, Penev, & Van Cauter, 2004) which could potentially increase the vulnerability to binge eat.

    View all citing articles on Scopus

    J. D. Shlisky is a research assistant, The Pennsylvania State University, University Park.

    T. J. Hartman is a professor and director, Diet Assessment Center, The Pennsylvania State University, University Park.

    P. M. Kris-Etherton is a university distinguished professor, The Pennsylvania State University, University Park.

    C. J. Rogers is an assistant professor and occupant of the Broadhurst Career Development Professorship for the Study of Health Promotion and Disease Prevention, Department of Nutritional Sciences, The Pennsylvania State University, University Park.

    N. A. Sharkey is a professor, Department of Kinesiology, and associate dean of research and graduate education, College of Health and Human Development, The Pennsylvania State University, University Park.

    S. M. Nickols-Richardson is a professor and professor-in-charge of the Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, The Pennsylvania State University, University Park.

    FUNDING/SUPPORT There is no funding to disclose.

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST T. J. Hartman has a consulting agreement with the International Life Sciences Institute. P. M. Kris-Etherton serves on advisory boards for Abunda, the California Walnut Commission, Campbell Soup Company, MonaVie, and Unilever and discloses research funding from General Mills, Inc, and The Peanut Institute. S. M. Nickols-Richardson has received research funding from General Mills, Inc, The Hershey Company, and the Dairy Research Institute. No potential conflict of interest was reported by the other authors.

    Meets Learning Need Codes 4000, 4090, 5370, and 9020. To take the Continuing Professional Education quiz for this article, log in to www.eatright.org, click the “myAcademy” link under your name at the top of the homepage, select “Journal Quiz” from the menu on your myAcademy page, click “Journal Article Quiz” on the next page, and then click the “Additional Journal CPE Articles” button to view a list of available quizzes, from which you may select the quiz for this article.

    View full text