Changes in eating patterns in response to chronic insufficient sleep and their associations with diet quality: a randomized trial

Study Objectives: Insufficient sleep leads to overconsumption, but the factors contributing to this effect are poorly understood. Therefore, we assessed the influence of prolonged curtailment of sleep on free-living eating patterns linked with overconsumption and explored associations of these eating patterns with diet quality under different sleep conditions. Methods: Sixty-five adults (47 females) participated in outpatient randomized crossover studies with two 6-week conditions: adequate sleep (7-9 h/night) and sleep restriction (-1.5 h/night relative to screening). Food records were collected over 3 nonconsecutive days, from which we ascertained data on eating frequency, midpoint, and window and intakes of energy and nutrients. Linear mixed models were used to assess the impact of sleep condition on change in eating pattern (sleep x week interaction) and the relation between eating patterns and dietary intakes (sleep x eating pattern interaction). Results: Sleep condition impacted the change in eating frequency across weeks, with eating frequency increasing in sleep restriction relative to adequate sleep (beta = 0.3 +/- 0.1; P =.046). Across conditions, eating more frequently tended to relate to higher energy intakes (beta = 60.5 +/- 34.6; P =.082). Sleep also influenced the relation of variability in eating midpoint with intakes of saturated fat (beta = 6.0 +/- 2.1; P =.005), polyunsaturated fat (beta = 23.9 +/- 2.0; P =.051), and added sugar (beta = 17.3 +/- 6.2; P =.006), with greater midpoint variability associated with more adverse changes in these diet quality components in sleep restriction vs adequate sleep. Conclusions: Chronic short sleep increases eating frequency and adversely influences associations of variability in meal timing with components of diet quality. These findings help to explain how short sleep leads to overconsumption and obesity.