Skip to main content

Preventing Weight Gain Improves Sleep Quality Among Black Women: Results from a RCT

Abstract

Background

Obesity and poor sleep are highly prevalent among Black women.

Purpose

We examined whether a weight gain prevention intervention improved sleep among Black women.

Methods

We conducted a randomized trial comparing a 12-month weight gain prevention intervention that included self-monitoring through mobile technologies and phone coaching to usual care in community health centers. We measured sleep using the Medical Outcomes Study Sleep Scale at baseline, 12 months, and 18 months. The scale examines quantity of sleep, sleep disturbance, sleep adequacy, daytime somnolence, snoring, shortness of breath, and global sleep problems (sleep problem indices I and II).

Results

Participants (n = 184) were on average 35.4 years and obese (BMI 30.2 kg/m2); 74% made <$30,000/year. At baseline, average sleep duration was 6.4 (1.5) hours. Controlling for weight change and sleep medication, the intervention group reported greater improvements in sleep disturbance [−8.35 (−16.24, −0.45)] and sleep problems at 12 months: sleep problem index I [−8.35 (−16.24, −0.45)]; sleep problem index II [−8.35 (−16.24, −0.45)]. However, these findings did not persist at 18 months.

Conclusions

Preventing weight gain may afford clinical benefit on improving sleep quality.

Trial Registration Number

The trial was registered with the ClinicalTrials.gov database (NCT00938535)

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS data brief. 2015(219):1–8

  2. Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Archives of internal medicine. 2001;161(13):1581.

    CAS  Article  PubMed  Google Scholar 

  3. Liu Y, Wheaton AG, Chapman DP, Cunningham TJ, Lu H, Croft JB. Prevalence of healthy sleep duration among adults—United States, 2014. MMWR Morbidity and Mortality Weekly Report 2016;65(6):137–41.

    Article  PubMed  Google Scholar 

  4. National Sleep Foundation. Adult Sleep Habits. Washington, DC: 2002 2002. Report No

  5. Buysse DJ. Sleep health: can we define it? Does it matter Sleep. 2014;37(1):9–17.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Jennings JR, Muldoon MF, Hall M, Buysse DJ, Manuck SB. Self-reported sleep quality is associated with the metabolic syndrome. Sleep. 2007;30(2):219–23.

    Article  PubMed  Google Scholar 

  7. Hoevenaar-Blom MP, Spijkerman A, Kromhout D, van den Berg JF, Verschuren W. Sleep duration and sleep quality in relation to 12-year cardiovascular disease incidence: the MORGEN study. Sleep. 2011;34(11):1487–92.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Pyykkönen A-J, Isomaa B, Pesonen A-K, Eriksson JG, Groop L, Tuomi T, et al. Subjective sleep complaints are associated with insulin resistance in individuals without diabetes. The PPP-Botnia study. Diabetes care. 2012;35(11):2271–8.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Laugsand LE, Vatten LJ, Platou C, Janszky I. Insomnia and the risk of acute myocardial infarction a population study. Circulation. 2011;124(19):2073–81.

    Article  PubMed  Google Scholar 

  10. Stranges S, Dorn JM, Cappuccio FP, Donahue RP, Rafalson LB, Hovey KM, et al. A population-based study of reduced sleep duration and hypertension: the strongest association may be in premenopausal women. J Hypertens. 2010;28(5):896–902.

    CAS  Article  PubMed  Google Scholar 

  11. Chaput JP, Despres JP, Bouchard C, Tremblay A. Association of sleep duration with type 2 diabetes and impaired glucose tolerance. Diabetologia. 2007;50(11):2298–304.

    Article  PubMed  Google Scholar 

  12. Cappuccio FP, Cooper D, D’Elia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J. 2011;32(12):1484–92.

    Article  PubMed  Google Scholar 

  13. Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. 2010;33(5):585–92.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Vgontzas AN, Liao D, Bixler EO, Chrousos GP, Vela-Bueno A. Insomnia with objective short sleep duration is associated with a high risk for hypertension. Sleep. 2009;32(4):491–7.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Van Dongen HP, Maislin G, Mullington JM, Dinges DF. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep-NEW YORK THEN WESTCHESTER-. 2003;26(2):117–29.

    Google Scholar 

  16. Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S, et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep. 2008;31(5):619–26.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring, Md). 2008;16(3):643–53.

    Article  Google Scholar 

  18. Marshall NS, Glozier N, Grunstein RR. Is sleep duration related to obesity? A critical review of the epidemiological evidence. Sleep medicine reviews. 2008;12(4):289–98.

    Article  PubMed  Google Scholar 

  19. Gangwisch JE, Malaspina D, Boden-Albala B, Heymsfield SB. Inadequate sleep as a risk factor for obesity: analyses of the NHANES I. Sleep. 2005;28(10):1289–96.

    Article  PubMed  Google Scholar 

  20. Grandner MA, Chakravorty S, Perlis ML, Oliver L, Gurubhagavatula I. Habitual sleep duration associated with self-reported and objectively determined cardiometabolic risk factors. Sleep medicine. 2014;15(1):42–50.

    Article  PubMed  Google Scholar 

  21. Wu Y, Zhai L, Zhang D. Sleep duration and obesity among adults: a meta-analysis of prospective studies. Sleep medicine. 2014;15(12):1456–62.

    Article  PubMed  Google Scholar 

  22. Jean-Louis G, Youngstedt S, Grandner M, Williams NJ, Sarpong D, Zizi F, et al. Unequal burden of sleep-related obesity among black and white Americans. Sleep health. 2015;1(3):169–76.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Krishnan V, Collop NA. Gender differences in sleep disorders. Current opinion in pulmonary medicine. 2006;12(6):383–9.

    Article  PubMed  Google Scholar 

  24. National Sleep Foundation Summary of Findings: 2005 Sleep in America Poll. Washington, DC: 2005

  25. Owens JF, Matthews KA. Sleep disturbance in healthy middle-aged women. Maturitas. 1998;30(1):41–50.

    CAS  Article  PubMed  Google Scholar 

  26. Lauderdale DS, Knutson KL, Yan LL, Rathouz PJ, Hulley SB, Sidney S, et al. Objectively measured sleep characteristics among early-middle-aged adults: the CARDIA study. American journal of epidemiology. 2006;164(1):5–16.

    Article  PubMed  Google Scholar 

  27. Mezick EJ, Matthews KA, Hall M, Strollo Jr PJ, Buysse DJ, Kamarck TW, et al. Influence of race and socioeconomic status on sleep: Pittsburgh Sleep SCORE project. Psychosom Med. 2008;70(4):410.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Verhoef SP, Camps SG, Gonnissen HK, Westerterp KR, Westerterp-Plantenga MS. Concomitant changes in sleep duration and body weight and body composition during weight loss and 3-mo weight maintenance. The American journal of clinical nutrition. 2013;98(1):25–31.

    CAS  Article  PubMed  Google Scholar 

  29. Chaput JP, Drapeau V, Hetherington M, Lemieux S, Provencher V, Tremblay A. Psychobiological impact of a progressive weight loss program in obese men. Physiology & behavior. 2005;86(1–2):224–32.

    CAS  Article  Google Scholar 

  30. Chaput JP, Klingenberg L, Astrup A, Sjödin AM. Modern sedentary activities promote overconsumption of food in our current obesogenic environment. Obesity Reviews. 2011;12(5):e12-e20.

    Article  PubMed  Google Scholar 

  31. Passos GS, Poyares D, Santana MG, Teixeira AA, Lira FS, Youngstedt SD, et al. Exercise improves immune function, antidepressive response, and sleep quality in patients with chronic primary insomnia. BioMed Research International. 2014;2014:1–7

  32. St-Onge M-P, Shechter A. Sleep disturbances, body fat distribution, food intake and/or energy expenditure: pathophysiological aspects. Hormone molecular biology and clinical investigation. 2014;17(1):29–37.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  33. Lovin S, Bercea R, Cojocaru C, Rusu G, Mihăescu T. Body composition in obstructive sleep apneahypopnea syndrome bio-impedance reflects the severity of sleep apnea. Multidisciplinary respiratory medicine. 2010;5(1):1.

    Article  Google Scholar 

  34. Stevens J, Cai J, Jones DW. The effect of decision rules on the choice of a body mass index cutoff for obesity: examples from African American and white women. The American journal of clinical nutrition. 2002;75(6):986–92.

    CAS  PubMed  Google Scholar 

  35. Foley P, Levine E, Askew S, Puleo E, Whiteley J, Batch B, et al. Weight gain prevention among black women in the rural community health center setting: the Shape Program. BMC public health. 2012;12:305.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Bennett GG, Foley P, Levine E, Whiteley J, Askew S, Steinberg DM, et al. Behavioral treatment for weight gain prevention among black women in primary care practice: a randomized clinical trial. JAMA internal medicine. 2013;173(19):1770–7.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Steinberg DM, Askew S, Lanpher MG, Foley PB, Levine EL, Bennett GG. The effect of a “maintain, don’t gain” approach to weight management on depression among black women: results from a randomized controlled trial. American journal of public health. 2014;104(9):1766–73.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Bennett GG, Warner ET, Glasgow RE, Askew S, Goldman J, Ritzwoller DP, et al. Obesity treatment for socioeconomically disadvantaged patients in primary care practice. Archives of internal medicine. 2012;172(7):565–74.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Greaney ML, Quintiliani LM, Warner ET, et al. Weight management among patients at community health centers: the Be Fit Be Well study. Obesity Management. 2009;5:222–8.

    Article  Google Scholar 

  40. Bennett GG, Herring SJ, Puleo E, Stein EK, Emmons KM, Gillman MW. Web-based weight loss in primary care: a randomized controlled trial. Obesity (Silver Spring, Md). 2010;18(2):308–13.

    Article  Google Scholar 

  41. Kroenke K, Strine TW, Spitzer RL, Williams JB, Berry JT, Mokdad AH. The PHQ-8 as a measure of current depression in the general population. Journal of affective disorders. 2009;114(1–3):163–73.

    Article  PubMed  Google Scholar 

  42. Allen RP, Kosinski M, Hill-Zabala CE, Calloway MO. Psychometric evaluation and tests of validity of the Medical Outcomes Study 12-item Sleep Scale (MOS sleep). Sleep medicine. 2009;10(5):531–9.

    Article  PubMed  Google Scholar 

  43. Spritzer KL, Hays RD. MOS sleep scale: a manual for use and scoring, version 1.0. Los Angeles, CA: RAND; 2003:1–8

  44. Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey Protocol. Hyattsville: US Department of Health and Human Services, 2007. Report No.

    Google Scholar 

  45. Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep health. 2015;1(1):40–3.

    Article  Google Scholar 

  46. Sarkhosh K, Switzer NJ, El-Hadi M, Birch DW, Shi X, Karmali S. The impact of bariatric surgery on obstructive sleep apnea: a systematic review. Obesity surgery. 2013;23(3):414–23.

    Article  PubMed  Google Scholar 

  47. Toor P, Kim K, Buffington CK. Sleep quality and duration before and after bariatric surgery. Obesity surgery. 2012;22(6):890–5.

    Article  PubMed  Google Scholar 

  48. Alfaris N, Wadden TA, Sarwer DB, Diwald L, Volger S, Hong P, et al. Effects of a 2-year behavioral weight loss intervention on sleep and mood in obese individuals treated in primary care practice. Obesity. 2015;23(3):558–64.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Foster GD, Borradaile KE, Sanders MH, Millman R, Zammit G, Newman AB, et al. A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. Archives of internal medicine. 2009;169(17):1619–26.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Harsch IA, Konturek PC, Koebnick C, Kuehnlein PP, Fuchs FS, Pour Schahin S, et al. Leptin and ghrelin levels in patients with obstructive sleep apnoea: effect of CPAP treatment. European Respiratory Journal. 2003;22(2):251–7.

    CAS  Article  PubMed  Google Scholar 

  51. Spiegel K, Tasali E, Penev P, Van Cauter E. Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Annals of internal medicine. 2004;141(11):846–50.

    Article  PubMed  Google Scholar 

  52. Lundahl A, Nelson TD. Sleep and food intake: a multisystem review of mechanisms in children and adults. Journal of health psychology. 2015;20(6):794–805.

    Article  PubMed  Google Scholar 

  53. Hale L. Do DP. Racial differences in self-reports of sleep duration in a population-based study. Sleep. 2007;30(9):1096–103.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Krueger PM, Friedman EM. Sleep duration in the United States: a cross-sectional population-based study. American journal of epidemiology. 2009;169(9):1052–63.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Hall M, Bromberger J, Matthews K. Socioeconomic status as a correlate of sleep in African-American and Caucasian women. Annals of the New York Academy of Sciences. 1999;896(1):427–30.

    CAS  Article  PubMed  Google Scholar 

  56. Stamatakis KA, Kaplan GA, Roberts RE. Short sleep duration across income, education, and race/ethnic groups: population prevalence and growing disparities during 34 years of follow-up. Annals of epidemiology. 2007;17(12):948–55.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Jean-Louis G, Kripke DF, Ancoli-Israel S, Klauber MR, Sepulveda RS. Sleep duration, illumination, and activity patterns in a population sample: effects of gender and ethnicity. Biological psychiatry. 2000;47(10):921–7.

    CAS  Article  PubMed  Google Scholar 

  58. Whinnery J, Jackson N, Rattanaumpawan P, Grandner MA. Short and long sleep duration associated with race/ethnicity, sociodemographics, and socioeconomic position. Sleep. 2014;37(3):601–11.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Hale L, Troxel WM, Kravitz HM, Hall MH, Matthews KA. Acculturation and sleep among a multiethnic sample of women: the Study of Women’s Health Across the Nation (SWAN). Sleep. 2014;37(2):309–17.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Piccolo RS, Yang M, Bliwise DL, Yaggi HK, Araujo AB. Racial and socioeconomic disparities in sleep and chronic disease: results of a longitudinal investigation. Ethnicity & disease. 2013;23(4):499–507.

    Google Scholar 

  61. Peuhkuri K, Sihvola N, Korpela R. Diet promotes sleep duration and quality. Nutrition research. 2012;32(5):309–19.

    CAS  Article  PubMed  Google Scholar 

  62. Dashti HS, Scheer FA, Jacques PF, Lamon-Fava S, Ordovas JM. Short sleep duration and dietary intake: epidemiologic evidence, mechanisms, and health implications. Adv Nutr. 2015;6(6):648–59.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  63. Morselli L, Leproult R, Balbo M, Spiegel K. Role of sleep duration in the regulation of glucose metabolism and appetite. Best practice & research Clinical endocrinology & metabolism. 2010;24(5):687–702.

    CAS  Article  Google Scholar 

  64. Patterson RE, Emond JA, Natarajan L, Wesseling-Perry K, Kolonel LN, Jardack P, et al. Short sleep duration is associated with higher energy intake and expenditure among African-American and non-Hispanic white adults. The Journal of nutrition. 2014;144(4):461–6.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  65. Markwald RR, Melanson EL, Smith MR, Higgins J, Perreault L, Eckel RH, et al. Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain. Proceedings of the National Academy of Sciences. 2013;110(14):5695–700.

    CAS  Article  Google Scholar 

  66. Kim S, DeRoo LA, Sandler DP. Eating patterns and nutritional characteristics associated with sleep duration. Public health nutrition. 2011;14(05):889–95.

    Article  PubMed  Google Scholar 

  67. Youngstedt SD. Effects of exercise on sleep. Clinics in sports medicine. 2005;24(2):355–65.

    Article  PubMed  Google Scholar 

  68. Faulkner GE, Taylor AH. Exercise, Health and Mental Health: Emerging Relationships. Routledge; London and New York: Taylor & Francis; 2005.

  69. Kubitz KA, Landers DM, Petruzzello SJ, Han M. The effects of acute and chronic exercise on sleep. Sports Medicine. 1996;21(4):277–91.

    CAS  Article  PubMed  Google Scholar 

  70. Fogelholm M, Vainio H. Weight control, physical activity and cancer—strong links. Obes Rev. 2002;3(1):1–3.

    CAS  Article  PubMed  Google Scholar 

  71. Breslau N, Roth T, Rosenthal L, Andreski P. Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry. 1996;39(6):411–8.

    CAS  Article  PubMed  Google Scholar 

  72. Ford DE, Cooper-Patrick L. Sleep disturbances and mood disorders: an epidemiologic perspective. Depression and anxiety. 2001;14(1):3–6.

    CAS  Article  PubMed  Google Scholar 

  73. Baglioni C, Battagliese G, Feige B, Spiegelhalder K, Nissen C, Voderholzer U, et al. Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. Journal of affective disorders. 2011;135(1–3):10–9.

    Article  PubMed  Google Scholar 

  74. Smith MT, Wegener ST. Measures of sleep: the Insomnia Severity Index, Medical Outcomes Study (MOS) Sleep Scale, Pittsburgh Sleep Diary (PSD), and Pittsburgh Sleep Quality Index (PSQI). Arthritis Care & Research. 2003;49(S5):S184-S96.

    Article  Google Scholar 

  75. Pearson NJ, Johnson LL, Nahin RL. Insomnia, trouble sleeping, and complementary and alternative medicine analysis of the 2002 National Health Interview Survey Data. Arch Intern Med. 2006;166(16):1775–1782.

    Article  PubMed  Google Scholar 

  76. Bertisch SM, Herzig SJ, Winkelman JW, Buettner C. National use of prescription medications for insomnia: NHANES 1999–2010. Sleep. 2014;37(2):343–349.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We express deep gratitude to the administration and staff of Piedmont Health for their continued collaboration and participation in the Shape Program. Most importantly, we would especially like to thank the women who participated in Shape.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dori M. Steinberg PhD, MS, RD.

Ethics declarations

Funding

This trial was funded by grant R01DK078798 from the National Institute for Diabetes and Digestive and Kidney Diseases. D.M. Steinberg is supported by the Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) Career Development award (K12HD043446-15). G.G. Bennett was supported by grant K22CA126992 from the National Cancer Institute. The funder had no role in the study design, data collection, data analysis, and interpretation of the data, in the writing of the report, and in the decision to submit the article for publication.

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors Dori Steinberg and Gary G. Bennett have equity in Scale Down, LLC, that produces mobile applications for weight loss. Dr. Bennett also has equity in Coeus Health and serves on Nutrisystem’s scientific advisory board. Authors Jacob Christy, Bryan C. Batch, Sandy Askew, Reneé H. Moore, and Portia Parker declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

About this article

Verify currency and authenticity via CrossMark

Cite this article

Steinberg, D.M., Christy, J., Batch, B.C. et al. Preventing Weight Gain Improves Sleep Quality Among Black Women: Results from a RCT. ann. behav. med. 51, 555–566 (2017). https://doi.org/10.1007/s12160-017-9879-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-017-9879-z

Keywords

  • Sleep
  • Obesity
  • Weight gain prevention
  • Minority health
  • Primary care
  • Digital health