Insufficient sleep predicts poor weight loss maintenance after 1 year

Sleep. 2023 May 10;46(5):zsac295. doi: 10.1093/sleep/zsac295.

Abstract

Study objectives: Insufficient sleep may attenuate weight loss, but the role of sleep in weight loss maintenance is unknown. Since weight regain after weight loss remains a major obstacle in obesity treatment, we investigated whether insufficient sleep predicts weight regain during weight loss maintenance.

Methods: In a randomized, controlled, two-by-two factorial study, 195 adults with obesity completed an 8-week low-calorie diet and were randomly assigned to 1-year weight loss maintenance with or without exercise and liraglutide 3.0 mg/day or placebo. Sleep duration and quality were measured before and after the low-calorie diet and during weight maintenance using wrist-worn accelerometers (GENEActiv) and Pittsburgh Sleep Quality Index (PSQI). To test associations between insufficient sleep and weight regain, participants were stratified at randomization into subgroups according to sleep duration (</≥6 h/night) or sleep quality (PSQI score ≤/>5).

Results: After a diet-induced 13.1 kg weight loss, participants with short sleep duration at randomization regained 5.3 kg body weight (p = .0008) and had less reduction in body fat percentage compared with participants with normal sleep duration (p = .007) during the 1-year weight maintenance phase. Participants with poor sleep quality before the weight loss regained 3.5 kg body weight compared with good quality sleepers (p = .010). During the weight maintenance phase, participants undergoing liraglutide treatment displayed increased sleep duration compared with placebo after 26 weeks (5 vs. -15 min/night) but not after 1 year. Participants undergoing exercise treatment preserved the sleep quality improvements attained from the initial weight loss.

Conclusions: Short sleep duration or poor sleep quality was associated with weight regain after weight loss in adults with obesity.

Trial registration: ClinicalTrials.gov NCT04122716.

Keywords: GLP-1 receptor agonist; exercise; obesity; sleep duration; sleep quality; weight loss maintenance.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Humans
  • Liraglutide* / pharmacology
  • Liraglutide* / therapeutic use
  • Obesity / complications
  • Obesity / drug therapy
  • Sleep Deprivation* / complications
  • Weight Gain
  • Weight Loss

Substances

  • Liraglutide

Associated data

  • EudraCT/2015-005585-32
  • ClinicalTrials.gov/NCT04122716