Project REST: Regulation of Eating and Sleep Topography
Study Details
Study Description
Brief Summary
Overweight/obesity and inadequate sleep are prevalent, and frequently co-occurring, health risks among children, both of which are associated with serious medical and psychosocial health complications including risk for cardiovascular disease. Although the investigator's data suggest that disrupted or shortened sleep may be causally associated with increased energy intake and weight gain in children, and with self-regulation and neural response to food cues in adults, understanding of mechanisms involved in the sleep/eating association is incomplete, thereby impeding development of targeted, optimally timed intervention strategies. The proposed mechanistic clinical trial aims to assess the effects of an experimental sleep manipulation on eating-related self-regulation and its neural substrates, and on real-world eating behavior, among children with overweight/obesity, which will help guide research efforts towards the refinement of prevention and intervention strategies targeting sleep and its eating-related correlates to curb weight gain throughout development.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Detailed Description
Insufficient sleep and excess weight status contribute to adverse health outcomes across the lifespan, including risk for cardiometabolic disease. Cross-sectional data suggest that children with overweight/obesity are more likely to experience sleep disturbances than their non-overweight peers. Although the nature of this association may be bidirectional, prospective studies indicate that sleep impacts body weight regulation through multiple physiological and psychological pathways. In particular, insufficient sleep is related to greater energy intake and reduced diet quality in children. Although mechanisms explaining the association between sleep and eating behavior are poorly understood, sleep restriction has been found to impact brain processes related to reward valuation of food and self-regulation, the behavioral manifestations of which may increase susceptibility to suboptimal dietary behaviors and subsequent weight gain. A limitation of prior research on mechanisms is that much of it has been conducted in adults and in laboratory settings, thereby calling into question the ecological validity of the findings. Alternatively, studies on sleep restriction/extension in children's natural environments have relied on retrospective reporting of eating behavior, included children across the weight spectrum, and had limited focus on underlying mechanisms, particularly neural substrates. A clearer understanding of momentary mechanisms involved in the sleep/eating association could improve development and/or refinement of sleep-related interventions, particularly those delivered in real time when risk for engaging in maladaptive eating is highest. The proposed R01 study will examine prospective associations among sleep, eating-related self-regulation, and eating behavior in the natural environment. Community-based children with overweight or obesity (n=120) will undergo a naturalistic protocol involving assessment of typical sleep and eating patterns (week 1), followed by sleep restriction or extension (weeks 2 and 3, separated by a 7-day wash-out), the latter occurring within a randomized crossover design. Assessment throughout the study period will involve daily actigraphy measurement of sleep patterns; repeated daily self-reports on eating behavior and behavioral assessment of eating-related self-regulation; and intermittent 24-hour dietary recalls informed by daily real-time food photography. Participants will complete fMRI-based assessment of neural activation during an eating-related self-regulation task after each week-long period of sleep restriction and extension. Overall aims are to assess short-term effects of sleep extension versus restriction on eating-related self-regulation (including behavioral and neural performance) and naturalistic eating behavior. These data will clarify timing and trajectory of changes in eating behavior and self-regulatory mechanisms as a consequence of sleep patterns. The proposed study has clear potential to advance scientific and clinical understanding of mechanisms involved in the prospective associations between inadequate sleep and maladaptive eating in youth and inform interventions to alleviate their cumulative personal and societal burden.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Sleep restriction followed by extension Children will spend 8 hours in bed for one week, engage in one week of wash-out, and then spend 11 hours in bed for one week. |
Behavioral: Sleep restriction
Participants will be asked to restrict their time in bed to 8 hours each night for one week.
Other Names:
Behavioral: Sleep extension
Participants will be asked to extend their time in bed to 11 hours each night for one week.
Other Names:
|
Experimental: Sleep extension followed by restriction Children will spend 11 hours in bed for one week, engage in one week of wash-out, and then spend 8 hours in bed for one week. |
Behavioral: Sleep restriction
Participants will be asked to restrict their time in bed to 8 hours each night for one week.
Other Names:
Behavioral: Sleep extension
Participants will be asked to extend their time in bed to 11 hours each night for one week.
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Change in Weight Status [4 weeks]
BMI (body mass index)
- Change in Eating Behavior [4 weeks]
measured by 24-hour dietary recall
- Change in Eating Behavior [4 weeks]
measured by ecological momentary assessment
- Self-Regulatory Control [4 weeks]
as measured by the Go/No-Go task (errors and response latency)
Secondary Outcome Measures
- Sleep Patterns [2 weeks]
as measured by actigraph data
Eligibility Criteria
Criteria
Inclusion Criteria:
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overweight/obese
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right-handed
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willing to undergo a 30-minute MRI scan
Exclusion Criteria:
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average sleep time exceeds 10 hours/night
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previous eating disorder diagnosis and/or sleep or psychiatric conditions
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conditions affecting executive functioning (e.g., recent concussion, traumatic brain injury)
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braces/metal in body
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taking medication known to affect sleep/appetite (e.g., antihistamines, stimulants)
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receiving concurrent treatment for sleep or overweight/obesity
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | University of Pittsburgh | Pittsburgh | Pennsylvania | United States | 15213 |
2 | Weight Control & Diabetes Research Center | Providence | Rhode Island | United States | 02903 |
Sponsors and Collaborators
- University of Pittsburgh
- National Heart, Lung, and Blood Institute (NHLBI)
Investigators
None specified.Study Documents (Full-Text)
More Information
Additional Information:
Publications
None provided.- STUDY21070047
- R01HL147914