Evening Chronotype Is Associated with Changes in Eating Behavior, More Sleep Apnea, and Increased Stress Hormones in Short Sleeping Obese Individuals

Abstract

BackgroundShort sleep duration and decreased sleep quality are emerging risk factors for obesity and its associated morbidities. Chronotype, an attribute that reflects individual preferences in the timing of sleep and other behaviors, is a continuum from morningness to eveningness. The importance of chronotype in relation to obesity is mostly unknown. Evening types tend to have unhealthy eating habits and suffer from psychological problems more frequently than Morning types, thus we hypothesized that eveningness may affect health parameters in a cohort of obese individuals reporting sleeping less than 6.5 hours per night.Methodology and Principal FindingsBaseline data from obese (BMI: 38.5±6.4 kg/m2) and short sleeping (5.8±0.8 h/night by actigraphy) participants (n = 119) of the Sleep Extension Study were analyzed (www.ClinicalTrials.gov, identifier NCT00261898). Assessments included the Horne and Ostberg Morningness-Eveningness questionnaire, a three-day dietary intake diary, a 14-day sleep diary, 14 days of actigraphy, and measurements of sleep apnea. Twenty-four hour urinary free cortisol, 24 h urinary norepinephrine and epinephrine levels, morning plasma ACTH and serum cortisol, fasting glucose and insulin, and lipid parameters were determined. Eveningness was associated with eating later in the day on both working and non-working days. Progression towards eveningness was associated with an increase in BMI, resting heart rate, food portion size, and a decrease in the number of eating occasions and HDL-cholesterol. Evening types had overtly higher 24 h urinary epinephrine and morning plasma ACTH levels, and higher morning resting heart rate than Morning types. In addition, Evening types more often had sleep apnea, independent of BMI or neck circumference.ConclusionsEveningness was associated with eating later and a tendency towards fewer and larger meals and lower HDL-cholesterol levels. In addition, Evening types had more sleep apnea and higher stress hormones. Thus, eveningness in obese, chronically sleep-deprived individuals compounds the cardiovascular risk associated with obesity.

Is the chronotype associated with obstructive sleep apnea?

“…Recently, Lucassen et al [28] evaluated obese participants (BMI 30-55 kg/m 2 ) ages 18 to 50 years from the Sleep Extension Study by a portable screening device. Eveningtype individuals presented with OSA approximately two times more than morningness individuals independent of BMI and neck circumference.…”

Evening chronotype associates with obesity in severely obese subjects: interaction with CLOCK 3111T/C

“…In this questionnaire, individuals can be stratified by circadian preference subjectively reported as morning, evening, and neutral type. This circadian preference has been related to several metabolic disturbances 7,8 . Indeed, Yu et al 7 has recently reported that eveningness is significantly linked with metabolic syndrome when compared to morningness.…”

Sleep in obese patients

“…E. Lucassen с соавт. (2013) продемонстрировали статистически значимое повы-шение ИМТ, стрессовых гормонов (АКТГ в плазме крови в утреннее время, суточной экскреции и адре-налина) и снижение уровней ХС-ЛПВП у больных ожирением с вечерним хронотипом и сном продолжи-тельностью менее 6,5 ч в сутки [15]. У больных ожи-рением с наличием полиморфизма 3111C clock-гена, связанного с вечерним хронотипом (основная группа), отмечались худшие показатели по динамике массы тела через 30 недель немедикаментозной терапии ожи-рения по сравнению с контрольной группой без дан-ных генетических изменений (р=0,039) [16].…”

“…Данные вы-воды согласуются с результатами проведенных ранее исследований, в частности в работе E. Lucassen с соавт. (2013 г) показана достоверная связь вечернего хроно-типа с аномальными формами приема пищи (вечерняя еда, уменьшение количества приемов пищи, увеличе-ние объема порций и их потребление преимущественно во второй половине дня) и высоким уровнем стрессо-вых гормонов у больных ожирением [15]. В отличие от этой работы, по нашим результатам отсутствовала значимая связь хронотипа с СОАС и гормонально-ме-таболическими показателями, а также не выявлено его влияния на степень снижения массы тела.…”