Sleep fragmentation and the risk of obesity: The Sleep Heart Health Study

Zhao, Binbin; Sun, Shuliu; He, Xijing; Yang, Jian; Ma, Xiancang; Yan, Bin

doi:10.1002/oby.23193

Cited by 13 publications

(7 citation statements)

References 32 publications

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“…Obesity is a major public health problem affecting 35% of US adults (1). Obesity leads to sleep fragmentation and unrefreshing sleep (2,3). In patients with obesity, a major source of sleep fragmentation is sleep-disordered breathing (SDB) (4,5).…”

Section: Introductionmentioning

confidence: 99%

Diet-induced obesity leads to sleep fragmentation independently of the severity of sleep-disordered breathing

Kim

Alexandre

Pho

et al. 2022

Journal of Applied Physiology

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Obesity is associated with sleep-disordered breathing (SDB) and unrefreshing sleep. Residual daytime sleepiness and sleep impairments often persist after SDB treatment in obese patients, which suggests an independent effect of obesity on breathing and sleep. However, examining the relationship between sleep architecture and SDB in obese patients is complex and can be confounded by multiple factors. The main goal of this study was to examine the relationship between obesity-related changes in sleep architecture and SDB. Sleep recordings were performed in 15 lean C57BL/6J and 17 diet-induced obesity (DIO) mice of the same genetic background. Arousals from sleep and apneas were manually scored. Respiratory arousals were classified as events associated with ≥30% drops in minute ventilation (VE) from baseline. We applied Poincaré analysis of VE during sleep to estimate breathing variability. Obesity augmented the frequency of arousals by 45% and this increase was independent of apneas. Respiratory arousals comprised only 15% of the arousals in both groups of mice. Breathing variability during NREM sleep was significantly higher in DIO mice, but it was not associated with arousal frequency. Our results suggest that obesity induces sleep fragmentation independently of SDB severity.

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Section: Introductionmentioning

confidence: 99%

Diet-induced obesity leads to sleep fragmentation independently of the severity of sleep-disordered breathing

Kim

Alexandre

Pho

et al. 2022

Journal of Applied Physiology

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“…Sleep plays a crucial role in cognitive processes such as attention (Stepanski et al, 1987), memory, and learning (Bonnet, 1985;Djonlagic et al, 2012), and fragmentation significantly impairs such functioning. Sleep-wake fragmentation is also linked to an increased risk of physical disorders, including obesity (Wang et al, 2014;Zhao et al, 2021), metabolic dysregulation (Stamatakis and Punjabi, 2010), and cardiovascular problems like hypertension and heart disease (Stamatakis and Punjabi, 2010). Sleep and mental health have a bidirectional relationship, such that sleep-wake fragmentation contributes to developing and worsening mental health disorders through increasing stress levels (Tartar et al, 2009), anxiety (Grubac et al, 2019), and depression (Pesonen et al, 2019), while mental health disorders can also induce sleep-wake fragmentation (Lucchesi et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Timing of outdoor light exposure is associated with sleep-wake consolidation in community-dwelling older men

Lok,

Ancoli-Israel,

Ensrud

et al. 2023

Front. Sleep

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IntroductionA consolidated sleep-wake pattern is essential for maintaining healthy cognition in older individuals, but many suffer from sleep fragmentation that exacerbates age-related cognitive decline and worsens overall mental and physical health. Timed light exposure (light therapy) has been explored as a countermeasure, but mixed results have been obtained. To determine whether the timing of light exposure is important for sleep-wake consolidation, we analyzed the natural light diets of a cohort of community-dwelling older men.MethodsThe degree of sleep-wake fragmentation and light exposure patterns were obtained over a week using wrist actigraphy. Correlations between fragmentation, light patterns, and various physical and mental health measures were examined (n = 877).ResultsOur findings revealed that higher sleep-wake fragmentation correlated with poorer physical and mental health and reduced cognition. Moreover, reduced daytime light exposure was associated with increased sleep-wake fragmentation. Interestingly, morning and evening light exposure (>1,000 lux) were not useful in distinguishing between low and high sleep-wake fragmentation scores, while increased afternoon light exposure showed much better discrimination. Specifically, optimal discrimination between low and high fragmentation occurred 6.7 h after habitual sleep offset. This suggests that afternoon light therapy might be more efficient in consolidating sleep and wake in older adults, particularly in those with low-amplitude circadian rhythms.DiscussionThis study highlights the significance of properly-timed light exposure in promoting consolidated sleep and cognitive health among older individuals. Tailored light-based strategies may have the potential to enhance physical, mental, and cognitive well-being in the aging population.

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“…In this study, a daily multivitamin supplement and 2000-2500 mL water were recommended to prevent the risk of complications, and regular face-to-face interviews were recommended to monitor complications. Behavioral interventions, such as going to sleep early [38,39], eating an average frequency of 5 times a day [40], avoiding prolonged periods of sitting [41] and eating vegetables and protein first [42], were also advised to develop healthy habits. There were no serious adverse events, which was in consistent with a previous literature [16].…”

Section: Discussionmentioning

confidence: 99%

Effects of an Intermittent Fasting 5:2 Plus Program on Body Weight in Chinese Adults with Overweight or Obesity: A Pilot Study

Kang¹,

Shi²,

Fu³

et al. 2022

Nutrients

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To retrospectively review the efficacy of intermittent fasting 5:2 plus program (30% of energy requirements on fast days and 70% of energy requirements on nonfasting days) in Chinese patients with overweight or obesity. This retrospective cohort study evaluated weight loss outcomes of patients treated with 12 weeks weight loss program in clinic. Adults with overweight or obesity participated in intermittent fasting 5:2 plus, daily calorie restriction (70% of energy requirements every day) or daily calorie restriction with meal replacement (70% of energy requirements every day, partly provided with high-protein meal replacement) programs for 12 weeks. The primary objective was to compare the weight loss of three groups. The primary outcome measure was the change in the % total weight loss. A total of 131 patients (35.3 ± 10.1 years; 81.7% female) were included, and the mean weight loss was 7.8 ± 4.4 % after 12 weeks. The intermittent fasting 5:2 plus group (n = 42) achieved 9.0 ± 5.3 % weight loss, compared with 5.7 ± 3.7 % in the daily calorie restriction group (n = 41) (p < 0.001) and 8.6 ± 3.5 % in the meal replacement group (n = 48) (p = 0.650). A total of 85.7% of patients in the intermittent fasting 5:2 plus group lost more than 5% body weight, vs. 58.5% in the daily calorie restriction group (p = 0.008), and 45.2% lost more than 10% body weight, vs.14.6% in the daily calorie restriction group (p = 0.005). No serious adverse events were reported in the three groups. The intermittent fasting 5:2 plus program more effectively led to weight loss than daily calorie restriction in the short-term in Chinese patients with overweight or obesity. A longer-term prospective randomized controlled trial is needed.

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Sleep fragmentation and the risk of obesity: The Sleep Heart Health Study

Cited by 13 publications

References 32 publications

Diet-induced obesity leads to sleep fragmentation independently of the severity of sleep-disordered breathing

Diet-induced obesity leads to sleep fragmentation independently of the severity of sleep-disordered breathing

Timing of outdoor light exposure is associated with sleep-wake consolidation in community-dwelling older men

Effects of an Intermittent Fasting 5:2 Plus Program on Body Weight in Chinese Adults with Overweight or Obesity: A Pilot Study

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