Key points are not available for this paper at this time.
Abstract Introduction The purpose of this study was to evaluate the extent to which a sleep extension intervention optimized the well-established effects of a diet and physical activity lifestyle intervention on improved metabolic outcomes in adults with prediabetes (hemoglobin A1c ≥5.7% and ≤6.4%) and short sleep duration (≤6.5 hours/night actigraphy-estimated sleep). Methods 157 eligible adults (mean age=52.16 years, 69% female, 66% White, 36% Black, 11% Asian, 7% other race) were randomized to an 8-week lifestyle plus sleep extension (n=88) versus lifestyle control (n=69) condition. Participants completed pre and post assessments of device-estimated glucose, sleep, and waist circumference. Self-reported sleep quality and daytime sleepiness were also assessed. Paired sample t-tests modeled pre to post-intervention changes in these measures. Results Device-estimated sleep duration increased significantly in both conditions intervention condition 17.04 (SD=42.98) minutes; control condition 24.18 (SD=38.10) minutes. Sleep onset time, sleep midpoint, and weekend sleep midpoint advanced in the intervention condition only -16.71 (SD=52.48) minutes, -9.40 (SD=38.82) minutes, -20.83 (SD=54.30) minutes, respectively. Sleep quality improved clinically and significantly in the intervention condition; mean Pittsburg Sleep Quality Index score decreased from 8.32 (SD=2.82) to 4.77 (SD=2.55). Sleep quality improved significantly in the control condition from 7.75 (SD=2.97) to 6.35 (SD=2.88). Between group differences in sleep quality change scores showed greater improvement in intervention versus control participants (p 0.001). Daytime sleepiness decreased significantly in both conditions (-3.15 intervention versus -1.18 control). Between group differences in daytime sleepiness showed greater improvement in intervention versus control participants (p 0.001). On average, waist circumference decreased by -0.74 (SD=5.19) cm. in the intervention and -1.56 (SD=5.21) cm. in the control condition; these changes scores did not differ significantly between conditions. There were no statistically significant improvements in devise-estimated glucose measures. Conclusion Adding sleep extension to a lifestyle change intervention improved several dimensions of sleep, beyond sleep duration, that have been associated with poor metabolic health (e.g. sleep times, sleep quality). The two conditions did not differentiate in terms of increasing sleep duration or decreasing waist circumference suggesting that individuals should at least have lifestyle interventions as a component of care. Neither condition improved glycemic outcomes. Support (if any) NIH (R00NR017416)
Malone et al. (Sat,) studied this question.