The American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023 featured preliminary research showing that individuals who reported getting regular, uninterrupted sleep were better at sticking to their exercise and diet regimens while attempting to lose weight. The conference provides the most recent information in terms of lifestyle and cardiometabolic health, as well as population-based health and wellness.
“Focusing on obtaining good sleep” may be a behavior that helps people stick to their physical activity and dietary modification goals, according to Christopher E. Kline, Ph.D., an associate professor in the department of health and human development at the University of Pittsburgh. “Good sleep” is defined as seven to nine hours at night with a regular wake time, as well as waking refreshed and being alert throughout the day. Better sleep health was linked to a much larger decrease of body weight and fat among participants in a 12-month behavioral weight loss program, according to a prior research of ours.
The researchers looked at whether people’s ability to stick to the different lifestyle changes suggested in a 12-month weight reduction program was associated with how well they slept. 125 persons (average age 50, 91% female, 81% white) who satisfied the criteria for overweight or obesity (body mass index of 27–24) and had no problems requiring medical monitoring of their diet or physical activity participated in the weight-loss program.
Using patient questionnaires, a sleep journal, and seven-day readings from a wrist-worn device that recorded sleep, waking activity, and rest, sleep patterns were assessed at the start of the program, at 6 months, and at 12 months. Six sleep-related measures—regularity, satisfaction, alertness, timing, efficiency (the proportion of time spent in bed while truly sleeping), and duration—were used to provide a “excellent” or “poor” rating to each participant. Each participant received a composite sleep health score ranging from 0 to 6, with one point awarded for each “excellent” indicator of sleep health. Higher scores denoted greater levels of sleep health.
A participant’s level of attendance at group intervention sessions, the proportion of days they consumed between 85 and 115% of their recommended daily caloric intake, and the amount of time they spent engaging in moderate to vigorous physical activity each day were all used to determine their level of adherence to the weight loss program. At the beginning of the research, six months into it, and a year afterwards, participants’ average sleep health score was 4.5 out of 6. At the beginning of the trial, at 6 months, and at 12 months, participants self-reported their daily calorie consumption using a smartphone app, and researchers monitored their physical activity using a waist-worn accelerometer for one week at a time.
The researchers discovered that better sleep health was linked to higher rates of attendance at group interval sessions, adherence to caloric intake goals, and improvement in time spent engaging in moderate-vigorous physical activity after adjusting the sleep health scores for age, gender, race, and whether or not a partner shared the bed. They discovered:
In the first six months, participants attended 79% of group meetings, whereas in the second six months, 62% of participants attended group sessions.
In the first six months and the second six months, participants reached their daily calorie intake targets on 36% and 21% of days, respectively.
In the first six months, participants’ total daily time engaged in moderate-vigorous exercise rose by 8.7 minutes; but, in the following six months, participants’ total time fell by 3.7 minutes.
According to Kline, the second six-month period saw a decline in group session attendance, calorie intake, and time spent engaging in moderate-vigorous exercise. “It’s natural for the adherence to weight reduction behaviors to diminish as one continues in a long-term behavioral weight loss strategy,” he added.
Also, while there was a relationship between improved sleep health ratings and an increase in physical activity, it was not statistically significant, so researchers cannot completely rule out the possibility that the outcomes were the product of chance.
He said, “We had expected that sleep would be connected with lifestyle change, but we didn’t expect to discover a connection between sleep health and all three of our measures of lifestyle modification. “Even though we did not influence the quality of sleep in this research, these findings indicate that enhancing sleep may improve adherence to lifestyle modifications.
The study’s drawbacks include the lack of an intervention to aid participants in improving their sleep, the fact that the study sample was not selected based on participant characteristics related to sleep health, and the fact that the overall sample population had reasonably good sleep health at baseline. Uncertainty exists about the generalizability of these findings to other diverse groups since the sample was largely white and female.
If we enhance a person’s sleep health, can we boost adherence to lifestyle adjustments and, eventually, promote weight loss? That is one subject of interest for future study, according to Kline.
The researchers’ next concern is how to timing such an intervention to enhance sleep.
“Whether it would be beneficial to prioritize sleep before rather than during attempts at weight reduction is yet unknown. To put it another way, should doctors advise their patients to prioritize having better and more regular sleep before they start trying to lose weight, or should they advise them to try to get better sleep while also changing their diet and activity levels? said Kline.
Everyone may take steps to enhance their sleep quality, which is a crucial part of the American Heart Association’s Life’s Essential 8 recommendations for cardiovascular health. In 2022, sleep was included as the eighth element of good cardiovascular health, joining a healthy diet, regular exercise, quitting smoking, sleeping enough to maintain a healthy weight, and managing blood pressure, sugar, and cholesterol levels. According to the American Heart Association’s 2023 Statistical Update, cardiovascular disease takes more lives each year in the U.S. than all types of cancer and chronic lower respiratory illness put together.
There are more than 100 studies that connect sleep deprivation to weight increase and obesity, but this study provided an excellent illustration of how sleep is linked not just to actual weight but also to the actions we take to control our own weight. This could be the case since sleep affects your metabolism, your capacity to control your metabolism, and your overall capacity to make healthy decisions, according to Michael A. Grandner, Ph.D., MTR. Grandner co-authored the Association’s Life’s Essential 8 cardiovascular health score and is the head of the University of Arizona’s Sleep and Health Research Program, the Behavioral Sleep Medicine Clinic, and Tucson, Arizona’s Banner-University Medical Center. “Research like this really illustrate how interconnected everything is, and sometimes sleep is the thing we can start controlling that may help open doors to other paths of health,” says the author.