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Sleep extension improves neurocognitive functions in chronically sleep-deprived obese individuals.

ABSTRACT: Sleep deprivation and obesity, are associated with neurocognitive impairments. Effects of sleep deprivation and obesity on cognition are unknown, and the cognitive long-term effects of improvement of sleep have not been prospectively assessed in short sleeping, obese individuals.To characterize neurocognitive functions and assess its reversibility.Prospective cohort study.Tertiary Referral Research Clinical Center.A cohort of 121 short-sleeping (<6.5 h/night) obese (BMI 30-55 kg/m(2)) men and pre-menopausal women.Sleep extension (468±88 days) with life-style modifications.Neurocognitive functions, sleep quality and sleep duration.At baseline, 44% of the individuals had an impaired global deficit score (t-score 0-39). Impaired global deficit score was associated with worse subjective sleep quality (p?=?0.02), and lower urinary dopamine levels (p?=?0.001). Memory was impaired in 33%; attention in 35%; motor skills in 42%; and executive function in 51% of individuals. At the final evaluation (N?=?74), subjective sleep quality improved by 24% (p<0.001), self-reported sleep duration increased by 11% by questionnaires (p<0.001) and by 4% by diaries (p?=?0.04), and daytime sleepiness tended to improve (p?=?0.10). Global cognitive function and attention improved by 7% and 10%, respectively (both p?=?0.001), and memory and executive functions tended to improve (p?=?0.07 and p?=?0.06). Serum cortisol increased by 17% (p?=?0.02). In a multivariate mixed model, subjective sleep quality and sleep efficiency, urinary free cortisol and dopamine and plasma total ghrelin accounted for 1/5 of the variability in global cognitive function.Drop-out rate.Chronically sleep-deprived obese individuals exhibit substantial neurocognitive deficits that are partially reversible upon improvement of sleep in a non-pharmacological way. These findings have clinical implications for large segments of the US population.www.ClinicalTrials.gov NCT00261898. NIDDK protocol 06-DK-0036.

SUBMITTER: Lucassen EA

PROVIDER: S-EPMC3903365 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Sleep extension improves neurocognitive functions in chronically sleep-deprived obese individuals.

Lucassen Eliane A EA Piaggi Paolo P Dsurney John J de Jonge Lilian L Zhao Xiong-ce XC Mattingly Megan S MS Ramer Angela A Gershengorn Janet J Csako Gyorgy G Cizza Giovanni G

PloS one 20140115 1

<h4>Background</h4>Sleep deprivation and obesity, are associated with neurocognitive impairments. Effects of sleep deprivation and obesity on cognition are unknown, and the cognitive long-term effects of improvement of sleep have not been prospectively assessed in short sleeping, obese individuals.<h4>Objective</h4>To characterize neurocognitive functions and assess its reversibility.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Tertiary Referral Research Clinical Center.<h4>Patients</ ...[more]

PMID: 24482677

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Project description:To evaluate the effects of study participation per se at the beginning of a sleep extension trial between screening, randomization, and the run-in visit.Subjects were screened, returned for randomization (Comparison vs. Intervention) after 81 days (median), and attended run-in visit 121 days later.Outpatient.Obese (N?=?125; M/F, 30/95; Blacks/Whites/Other, N?=?73/44/8), mean weight 107.6±19.7 kg, <6.5 h sleep/night.Non-pharmacological sleep extension.Sleep duration (diaries and actigraphy watch), sleep quality (Pittsburgh Sleep Quality Index), daily sleepiness (Epworth Sleepiness Scale), fasting glucose, insulin and lipids.Prior to any intervention, marked improvements occurred between screening and randomization. Sleep duration increased (diaries: 357.4 ±51.2 vs. 388.1±48.6 min/night; mean±SD; P<0.001 screening vs. randomization; actigraphy: 344.3 ±41.9 vs. 358.6±48.2 min/night; P<0.001) sleep quality improved (9.1±3.2 vs. 8.2±3.0 PSQI score; P<0.001), sleepiness tended to improve (8.9±4.6 vs. 8.3±4.5 ESS score; P?=?0.06), insulin resistance decreased (0.327±0.038 vs. 0.351±0.045; Quicki index; P<0.001), and lipids improved, except for HDL-C. Abnormal fasting glucose (25% vs. 11%; P?=?0.007), and metabolic syndrome (42% vs. 29%; P?=?0.007) both decreased. In absence of intervention, the earlier metabolic improvements disappeared at the run-in visit.Relatively small sample size.Improvements in biochemical and behavioral parameters between screening and randomization changed the "true" study baseline, thereby potentially affecting outcome. While regression to the mean and placebo effect were considered, these findings are most consistent with the "Hawthorne effect", according to which behavior measured in the setting of an experimental study changes in response to the attention received from study investigators. This is the first time that biochemical changes were documented with respect to the Hawthorne effect. The findings have implications for the design and conduct of clinical research.ClinicalTrials.gov NCT00261898.

Dataset Information

Sleep extension improves neurocognitive functions in chronically sleep-deprived obese individuals.

Publications

Sleep extension improves neurocognitive functions in chronically sleep-deprived obese individuals.

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