The Effect of Behavioral Sleep Interventions on Measures of Obesity, Dietary Intake and Physical Activity in Adults With Poor Sleep Health: A Systematic Review, Meta-Analysis and Meta-Regression Analysis

IF 7.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Reviews Pub Date : 2026-10-12 Epub Date: 2026-04-27 DOI:10.1111/obr.70139

Samiul A. Mostafa, Pushpa Singh, Feaz Babwah, Wasim Hanif, George Balanos, Krishnarajah Nirantharakumar, Jason G. Ellis, Abd A. Tahrani

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引用次数: 0

Abstract

Background

As poor sleep negatively impacts on adiposity, there is interest in examining whether improving sleep can improve adiposity markers. We reviewed studies aimed at improving sleep using (1) cognitive behavioral therapy for insomnia (CBT-I) and/or sleep hygiene and (2) sleep extension on adiposity markers, dietary intake, and physical activity.

Methods

Literature searches were performed on MEDLINE, Embase, CINAHL, and Cochrane Library. We included studies featuring adults ≥ 18 years without OSA, a sleep intervention as well as preintervention and postintervention measures.

Results

From a total of 27 studies, 25 were used in the meta-analyses. Using CBT-I and/or sleep hygiene in eight studies (n = 1384) led to significant BMI reductions averaging 0.64 kg/m² (0.28, 1.01, p = 0.0006, I² = 16%) but the reductions were not significant in five studies (n = 138) of sleep extension, 0.15 kg/m² (−0.40, 0.11, p = 0.26). In obesity (n = 78, 3 studies) and in type 2 diabetes (n = 1121, 3 studies) BMI reductions averaged 1.53 (0.49, 2.56, p = 0.004, I² = 0%) and 0.64 kg/m² (0.37, 0.92, p < 0.00001, I² = 0%), respectively. For body weight, using sleep interventions led to significant reductions in the obese (n = 72, 3 studies) and overweight ranges (n = 337, 6 studies), averaging 5.55 (4.13, 6.97, p < 0.00001, I² = 0%) and 0.83 kg (0.32, 1.35, p = 0.002, I² = 0%), respectively. Using sleep interventions reduced daily energy intake (n = 223, 5 studies) by 147.5 cal/day (5.74, 289.41, p = 0.04, I² = 53%), but was higher in the obese/overweight range (n = 122, 3 studies) at 238.0 cal/day (138.86, 337.22, p < 0.00001, I² = 0%); sugar consumption reduced (p = 0.05), and protein consumption increased (p = 0.001). There were no changes in physical activity or sedentary behavior levels. On quality assessment, 12 and 10 studies were of low and some concerns, respectively.

Conclusion

Addressing poor sleep health through using sleep interventions has the potential to be integrated into obesity management programs, alongside current lifestyle strategies.

PROSPERO Identification Number

CRD42025644060

Abstract Image

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睡眠行为干预对睡眠不良成人肥胖、饮食摄入和身体活动的影响：系统综述、meta分析和meta回归分析

背景：由于睡眠不足会对肥胖产生负面影响，因此人们对改善睡眠是否可以改善肥胖标志物的研究很感兴趣。我们回顾了旨在改善睡眠的研究(1)失眠认知行为疗法（CBT-I）和/或睡眠卫生；(2)肥胖标志物、饮食摄入和身体活动的睡眠延长。方法：在MEDLINE、Embase、CINAHL和Cochrane图书馆进行文献检索。我们纳入了年龄≥18岁的无阻塞性睡眠呼吸暂停、睡眠干预以及干预前和干预后措施的研究。结果：从27项研究中，25项被用于荟萃分析。在8项研究（n = 1384）中，使用CBT-I和/或睡眠卫生导致BMI显著降低，平均为0.64 kg/m2 (0.28, 1.01, p = 0.0006, I2 = 16%)，但在5项延长睡眠研究（n = 138）中，BMI降低不显著，平均为0.15 kg/m2 （-0.40, 0.11, p = 0.26）。在肥胖（n = 78, 3项研究）和2型糖尿病（n = 1121, 3项研究）中，BMI平均降低分别为1.53 （0.49,2.56,p = 0.004, 2 = 0%）和0.64 kg/m2 （0.37, 0.92, p = 0%）。对于体重，使用睡眠干预导致肥胖（n = 72, 3项研究）和超重（n = 337, 6项研究）的显著减少，平均分别为5.55 （4.13,6.97,p 2 = 0%）和0.83 kg （0.32, 1.35, p = 0.002, I2 = 0%）。使用睡眠干预使每日能量摄入（n = 223, 5项研究）减少了147.5卡/天（5.74,289.41,p = 0.04, I2 = 53%），但在肥胖/超重范围（n = 122, 3项研究）减少了238.0卡/天（138.86,337.22,p = 0%）；糖消耗减少（p = 0.05），蛋白质消耗增加（p = 0.001）。体力活动或久坐行为水平没有变化。在质量评价方面，分别有12项和10项研究的质量不高和值得关注。结论：通过使用睡眠干预来解决睡眠健康问题，有可能与当前的生活方式策略一起纳入肥胖管理计划。普洛斯彼罗识别号：CRD42025644060。

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来源期刊

Obesity Reviews 医学-内分泌学与代谢

CiteScore

19.30

自引率

1.10%

发文量

130

审稿时长

1 months

期刊介绍： Obesity Reviews is a monthly journal publishing reviews on all disciplines related to obesity and its comorbidities. This includes basic and behavioral sciences, clinical treatment and outcomes, epidemiology, prevention and public health. The journal should, therefore, appeal to all professionals with an interest in obesity and its comorbidities. Review types may include systematic narrative reviews, quantitative meta-analyses and narrative reviews but all must offer new insights, critical or novel perspectives that will enhance the state of knowledge in the field. The editorial policy is to publish high quality peer-reviewed manuscripts that provide needed new insight into all aspects of obesity and its related comorbidities while minimizing the period between submission and publication.