Abstract
This study aimed to assess the effects of quantity, quality and periodization of carbohydrates consumption on sleep. PubMed, SCOPUS and Cochrane Library were searched through October 2020. Data were pooled using random-effects meta-analysis. Eleven articles were included in the meta-analysis which consisted of 27 separate nutrition trials, resulting in 16 comparison data sets (sleep quantity n = 11; sleep quality n = 5). Compared to high carbohydrate (HCI), low carbohydrate intake (LCI) moderately increased duration and proportion of N3 sleep stage (ES = 0.37; 95% CI = 0.18, 0.56; p < 0.001 and ES = 0.51; 95% CI = 0.33, 0.69; p < 0.001, respectively). HCI prolonged rapid eye movement (REM) stage duration (ES = −0.38; 95% CI = 0.05, −8.05; p < 0.001) and proportion (ES = −0.46; 95% CI = −0.83, −0.01; p < 0.001), compared to LCI. The quality of carbohydrate intake did not affect sleep stages. Meta-regression showed that the effectiveness of carbohydrate quantity and quality in sleep onset latency was significantly explained by alterations of carbohydrate intake as a percentage of daily energy intake (R2 = 25.87, p = 0.018) and alterations in the glycemic load (R2 = 50.8, p = 0.048), respectively. Alterations in glycemic load partially explained the variance of the effectiveness of carbohydrate quality in sleep efficiency (R2 = 89.2, p < 0.001) and wake after sleep onset (R2 = 64.9, p = 0.018). Carbohydrate quantity was shown to affect sleep architecture, and especially N3 and REM sleep stages. Alterations in both quantity and quality of carbohydrate intake showed a significant effect on sleep initiation. Variations in carbohydrate quality significantly affected measures of sleep continuation. Further studies are needed to assess the effect of long-term carbohydrate interventions on sleep.
Highlights
Sleep constitutes a lifelong element of human existence
The quality of CHO intake did not show any significant effect on sleep stages
The current results highlight the effect of nutrition, and especially carbohydrates, on sleep
Summary
Sleep constitutes a lifelong element of human existence. It is defined as a reversible state of decreased or absent consciousness that initiates from wakefulness and evolves to light, deep and rapid eye movement (REM) sleep stages [1]. Alterations in sleep-related parameters are often part of physiological responses that may be induced by nutrition interventions and might be translated into modifications in sleep architecture [2], quantity or continuation [3]. The required sleep quantity varies among individuals and its adequacy is reflected by the absence of sleep-induced or sleep-related health issues, daytime dysfunction or sleepiness [4]. Its association with numerous diseases [7] underlined the necessity to examine practical and effective approaches, including manipulation of nutritional aspects to optimize sleep [8]
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