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Sleep-Aligned Extended Overnight Fasting Improves Nighttime and Daytime Cardiometabolic Function.
Daniela Grimaldi1, Kathryn J Reid1, Sabra M Abbott1
1Department of Neurology, Center for Circadian and Sleep Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Arteriosclerosis, Thrombosis, and Vascular Biology
|February 12, 2026
Summary
Extending overnight fasting by 3 hours, aligned with sleep, improved cardiometabolic health. This time-restricted eating approach enhanced autonomic balance and glucose regulation in adults.
Area of Science:
- Cardiology
- Metabolic Health
- Chronobiology
Background:
- Time-restricted eating (TRE) shows cardiometabolic benefits, but adherence is challenging.
- Existing TRE methods have fixed or unspecified fasting windows, neglecting sleep's role in metabolic regulation.
- An individualized approach aligning fasting with sleep may improve adherence and outcomes.
Purpose of the Study:
- To investigate if extending overnight fasting by 3 hours, aligned with habitual sleep, improves cardiometabolic health.
- To assess the impact on nighttime autonomic function, blood pressure, and glucose regulation.
- To compare this sleep-aligned TRE with habitual eating patterns.
Main Methods:
- Randomized parallel-arm controlled trial with 39 overweight/obese adults (36-75 years).
- Intervention group: 13-16 hour overnight fasting (last meal ≥3 hours before sleep).
- Control group: Habitual 11-13 hour overnight fasting. Intervention duration: 7.5 weeks.
Main Results:
- Extended overnight fasting significantly improved nighttime diastolic blood pressure dipping.
- Secondary outcomes showed improved nighttime autonomic function (heart rate, variability, cortisol) and glucose tolerance.
- No significant improvement in insulin sensitivity (Matsuda Index) was observed.
Conclusions:
- Extending overnight fasting by 3 hours, aligned with sleep, enhances cardiometabolic health in middle-aged/older adults.
- This approach improves coordination of circadian- and sleep-regulated autonomic and metabolic activity.
- Sleep-aligned TRE is a novel, accessible lifestyle intervention for cardiometabolic health.
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