November 2012 Question 2
The authors of the review stated, "caution should be taken when interpreting results of our review, due to the limited number of studies and small sample sizes of each study." If you were to design a sleep study to produce optimal results, how would you do it? What dietary factors would you measure (leptin, ghrelin, total energy expenditure, resting energy expenditure, total energy consumption, fat intake, snack intake, etc.)? Provide reasoning for your design.
posted by Unknown @ 3:30 PM
9 comments
9 Comments:
I would try to make it randomized study with a control group. I would have people randomly assigned into a group that was to attempt to get over 8 hours of sleep per night, a group ordered to get less than 6 hours of sleep per night, and a group given no instructions at all. I would measure diet, hormone levels, weight fluctuations, and subjective stress. As far as hormones I would look at leptin and ghrelin as well as c-reactive protein and other stress indicators. I would look at diet for total energy expenditure, fat intake, and carbohydrate intake (and timing of carbohydrate intake). I would also look at how much stimulants a person is getting and their physical activity level relative to their amount of sleep each day. I would look at these items to see if what they are eating and how they are sleeping has an effect on the body. Having them randomly assigned to a group may help to put people in a group they are not comfortable in which is more "real world" effects of lack of sleep.
I think I would choose to study either men or women as participants because I think it would be interesting to see results based on gender. Also, I think this may increase sample size if participants can relate to others in the study. Participants would randomly be placed in a group receiving 5 hours of sleep or a group receiving 7 hours of sleep over a 3 day period. I chose these durations because I feel that they are fairly realistic. I would definitely measure total energy consumption and expenditure, leptin, and ghrelin. It would also be beneficial to keep track of the times that participants were eating and the components of their meals/snacks. Serum leptin and ghrelin could be drawn after each night’s sleep to compare similarities/differences (if applicable) in levels in those who had 2 hours less or more than other participants. I think self reported satiety, appetite, and hunger would be important to compare between the 2 groups.
If I wanted to produce optimal results it would have to be study design that was applied across gender and weight status. Most of the studies reviewed focused on either normal weight or overweight/obese, and many focused solely on men.
Based on the recommendations of this article, the duration of the study should be extended to several weeks rather than just a few nights and use a more realistic definition of sleep deprivation such as 5-6 hrs compared to a baseline of 8 hrs.
As far as measurements, I would want participants to document their consumption and feelings in a detailed food and activity diary to measure the times of meals and snacks eaten, kcal, CHO, Pro, and Fat as well as feelings of hunger and satiety. TEE, RMR, and TEF would also be measured along with daily activity and feelings of tiredness from the diary. From a biochemical perspective I think it makes sense to measure the variety discussed in the review (leptin, ghrelin, insulin, glucose, thyroxin, TSH, etc) as there is not a consistent use of measures or results from these measures in prior studies.
I would study both men and women of otherwise healthy standing from across the country. I would track their intake with dietary records. I would also track # of sleep hours per night and have them log fatigue levels and emotions as well. Biochemically, I would track all labs mentioned by everyone else but would also track cortisol levels which tend to be elevated in people with sleep problems.
If I were to design this study to produce optimal results I would want to include an experimental group and a control group as well as study both men and women of different ages. It would important to implement this study for a longer period of time than just a few days in order to get a more practical idea of sleep patterns.
I would like to compare the number of hours of sleep each night with total energy expenditure, kcal consumption, and overall daily eating times and patterns throughout the day. Since it has been found that Leptin and Ghrelin are affected by sleep deprivation these labs would also be supporting factors in the association between sleep and food consumption so I would have these labs tested in all participants.
I agree with others that examining feelings toward hunger, satiety, sleep, etc would be important to explore. Some people tend to overeat due to the emotional aspects in their life and it would be interesting to see how sleep deprivation would also factor in.
I would have a control group and an experimental group in order to see differences in hormones. I would measures all the hormones that were pertinent to the study as well as total energy expenditure and total energy consumption in order to see kcal consumed versus kcal burned. The control group would need to get 8-10 hours of sleep while the experimental group would get less sleep. I would look at their information and determine how sleep affects these levels. I would try to have each person do everything else the same throughout the day so sleep was the only differing factor.
I think that I would do several things similarly to the studies reviewed in this publication to try to get similar results, but with a more reliable set-up. I would use a control group and several experimental groups that would produce results that include hormone levels, kcal intake/expenditure, amount of sleep, etc. I would also control for activity. It's so interesting that one of the studies Taylor highlighted didn't control for activity, which has a significant effect on weight status.
I would have 4 groups, male with >6 hours, male <6 hours, female >6 hours, female <6 hours. I chose >6 and <6 because it is hard to "make" someone sleep a certain length of time (7, 8, 9 hours) if their body does not need it. Doing more or less than 6 hours is realistic. I think it is very important to see the difference in gender. I would track this for a week. I would have them do a food record for the entire week also tracking what time they ate. I would have them track activity and at what times did they feel mentally or physically exhausted. I would have them abstain from caffeine so if they were already dependent on it I would ask that they withdraw from it for two weeks prior to the study (or however long it would take for them not to feel dependent on it-would check research). I would also ask them to track what times they felt very hungry. Leptin and ghrelin would be measured every night because they obviously have a big impact on intake but also to correlate those levels with how much they consumed, how often and at what times they felt very tired and very hungry. Also, looking at times they consumed snacks and the calories consumed at their meals. I just thought of this but I would have them track their normal habits the week prior to the study (time went to sleep and woke up, food diary, activity and at what times they felt hungry or tired). I think this will give baseline for the participants to see if any changes occurred with the change in amount of sleep. If a person normally sleeps <6 hours a night I would not want to put them in the <6 hour group because you would not see any changes and vice versa.
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