Consistent sleep onset and maintenance of body weight after weight loss: An analysis of data from the NoHoW trial

Abstract

Background Several studies have suggested that reduced sleep duration and quality are associated with an increased risk of obesity and related metabolic disorders, but the role of sleep in long-term weight loss maintenance (WLM) has not been thoroughly explored using prospective data. Methods and findings The present study is an ancillary study based on data collected on participants from the Navigating to a Healthy Weight (NoHoW) trial, for which the aim was to test the efficacy of an evidence-based digital toolkit, targeting self-regulation, motivation, and emotion regulation, on WLM among 1,627 British, Danish, and Portuguese adults. Before enrolment, participants had achieved a weight loss of ≥5% and had a BMI of ≥25 kg/m 2 prior to losing weight. Participants were enrolled between March 2017 and March 2018 and followed during the subsequent 12-month period for change in weight (primary trial outcome), body composition, metabolic markers, diet, physical activity, sleep, and psychological mediators/moderators of WLM (secondary trial outcomes). For the present study, a total of 967 NoHoW participants were included, of which 69.6% were women, the mean age was 45.8 years (SD 11.5), the mean baseline BMI was 29.5 kg/m 2 (SD 5.1), and the mean weight loss prior to baseline assessments was 11.4 kg (SD 6.4). Objectively measured sleep was collected using the Fitbit Charge 2 (FC2), from which sleep duration, sleep duration variability, sleep onset, and sleep onset variability were assessed across 14 days close to baseline examinations. The primary outcomes were 12-month changes in body weight (BW) and body fat percentage (BF%). The secondary outcomes were 12-month changes in obesity-related metabolic markers (blood pressure, low- and high-density lipoproteins [LDL and HDL], triglycerides [TGs], and glycated haemoglobin [HbA1c]). Analysis of covariance and multivariate linear regressions were conducted with sleep-related variables as explanatory and subsequent changes in BW, BF%, and metabolic markers as response variables. We found no evidence that sleep duration, sleep duration variability, or sleep onset were associated with 12-month weight regain or change in BF%. A higher between-day variability in sleep onset, assessed using the standard deviation across all nights recorded, was associated with weight regain (0.55 kg per hour [95% CI 0.10 to 0.99]; P = 0.016) and an increase in BF% (0.41% per hour [95% CI 0.04 to 0.78]; P = 0.031). Analyses of the secondary outcomes showed that a higher between-day variability in sleep duration was associated with an increase in HbA1c (0.02% per hour [95% CI 0.00 to 0.05]; P = 0.045). Participants with a sleep onset between 19:00 and 22:00 had the greatest reduction in diastolic blood pressure (DBP) ( P = 0.02) but also the most pronounced increase in TGs ( P...

Sleep Health Characteristics among Adults Who Attempted Weight Loss in the Past Year: NHANES 2017–2018

“…We found that a substantial proportion of adults attempting weight loss keep irregular sleeping schedules. Since prior research provides evidence that sleep regularity is associated with obesity and weight loss maintenance [ 37 , 38 ], weight loss interventions should be aware of the potential for poor sleep regularity in their population and should measure, and potentially address, irregular sleep patterns.…”

Hair Cortisol Concentration, Weight Loss Maintenance and Body Weight Variability: A Prospective Study Based on Data From the European NoHoW Trial

“…Objectively measured sleep was also collected using the Fitbit Charge 2. Sleep duration and sleep onset was assessed across the 14 days close to baseline examinations using a previously described approach ( 35 , 36 ). Mean daily sleep duration was calculated and included in analyses as a categorical variable: <6, 6–<7, 7–<8, 8–<9, and ≥9 hours.…”

“…To get associations independently of self-reported stress, sensitivity analyses additionally adjusted for the PSS were conducted. Moreover, since stress is closely related to sleep ( 39 ), and we have previously shown an association between sleep onset variability and weight regain among the NoHoW participants ( 35 ), sensitivity analyses were conducted adjusting for sleep duration and sleep onset variability. Analyses adjusted for hair washing frequency and use of hair dye were conducted as well, although the evidence for potential influence on HCC from these factors is inconsistent ( 21 , 40 ).…”

Examining the Role of Exercise Timing in Weight Management: A Review

“…Current evidence suggests that acute bouts of exercise [74,75] and chronic exercise training [74][75][76] improve subjective sleep quality and objectively derived measures of sleep. Because both sleep quality and sleep duration have been linked to body weight regulation [77][78][79][80], it is possible that sleep is a mediator in the relationship between exercise and weight loss. Below we review existing literature on whether the effect of acute and chronic exercise on parameters of sleep is dependent on time of day.…”