The effect of intermittent fasting on sleep in adults with overweight or obesity: a network meta-analysis of...

Overweight and obesity have become significant public health concerns. Three types of intermittent fasting (IF)-alternate-day fasting (ADF), time-restricted eating (TRE), and the 5:2 diet-have shown potential for weight loss. However, the effects of IF on sleep remain unclear.

Multiple databases were searched in January 2025. Randomized controlled trials (RCTs) in adults with overweight and obese that compared the effects of IF, continuous energy restriction (CER), and usual diet (UD) on sleep-related outcomes were eligible. The primary outcome was the global Pittsburgh Sleep Quality Index (PSQI) and secondary outcomes included PSQI components, the Epworth sleepiness scale, and other subjective and objective sleep parameters. A Bayesian network meta-analysis was performed. Sixteen trials were included. There were no significant differences in PSQI components among ADF, CER, TRE, the 5:2 diet, and the UD. ADF had a higher sleep latency score than CER and the UD (MD = 1.04, 95 % CI: 0.15-1.93; MD = 1.39, 95 % CI: 0.37-2.60, respectively). TRE had a longer time in bed than UD (MD = 26.04, 95 % CI: 3.36-48.73), and a longer sleep onset latency than CER (MD = 9.54, 95 % CI: 3.43-15.68). No differences were found for most other sleep parameters.

ADF and TRE were shown to have slight effects on some sleep parameters. However, due to limitations, such as small sample sizes and varying protocols of the included studies, the results should be interpreted cautiously. Well-designed and comprehensive studies are warranted.