Abstract
BackgroundAlthough insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain. Observational research suggests that being tired influences what children eat more than how active they are, but only experimental research can determine causality. Few experimental studies have been undertaken to determine how reductions in sleep duration might affect indices of energy balance in children including food choice, appetite regulation, and sedentary time. The primary aim of this study is to objectively determine whether mild sleep deprivation increases energy intake in the absence of hunger.MethodsThe Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design. One hundred and ten children aged 8–12 years, with normal reported sleep duration of 8–11 h per night will undergo 2 weeks of sleep manipulation; seven nights of sleep restriction by going to bed 1 hr later than usual, and seven nights of sleep extension going to bed 1 hr earlier than usual, separated by a washout week. During each experimental week, 24-h movement behaviours (sleep, physical activity, sedentary behaviour) will be measured via actigraphy; dietary intake and context of eating by multiple 24-h recalls and wearable camera images; and eating behaviours via objective and subjective methods. At the end of each experimental week a feeding experiment will determine energy intake from eating in the absence of hunger. Differences between sleep conditions will be determined to estimate the effects of reducing sleep duration by 1–2 h per night.DiscussionDetermining how insufficient sleep predisposes children to weight gain should provide much-needed information for improving interventions for the effective prevention of obesity, thereby decreasing long-term morbidity and healthcare burden.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12618001671257. Registered 10 October 2018.
Highlights
MethodsThe Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design
Insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain
Interest is growing in the potential for sleep as a novel component of weight management [5, 6], given the extensive observational literature demonstrating short sleep duration as a strong, independent risk factor for obesity in children [7,8,9,10], and promising experimental evidence indicating that sleep interventions can substantially reduce the risk of obesity in early childhood [11,12,13]
Summary
The DREAM study is a randomized cross-over trial testing how sleep deprivation influences eating behaviour and activity patterns in children. Primary caregivers (parents or legal guardians) of potentially eligible participants will access the screening questionnaire, the Sleep Disturbance Scale for Children (SDSC) [58], via the University of Otago Child and Teen Sleep Research Group on Facebook (see Table 1 for the timing of all study assessments). Caregivers will complete their own questionnaires while the children complete the free access phase of the experiment, which contains the pre-weighed and measured items listed in Table 4 and Fig. 3, where participants will be given the opportunity to eat highly palatable snacks (e.g. lollies, chips, chocolate) for 15 min without adult supervision.
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