Sleep Duration and Quality as Predictors of Weight Loss and Adherence During a Behavioral Weight Loss Intervention

To investigate the independent and combined associations between sleep duration and quality with weight loss and adherence in a behavioral weight loss intervention.

Adults with overweight/obesity (N = 296) participated in a 12-month intervention. Weight and sleep (Pittsburgh Sleep Quality Index) were assessed at baseline, 6 and 12 months. Analyses examined associations between baseline sleep and sleep changes with 6- and 12-month weight loss and intervention adherence (attendance, physical activity, caloric intake).

From a baseline weight of 97.0 ± 1.0 kg, participants lost 6.6 ± 1.1 kg (6.8%) at 6 months and 6.7 ± 1.2 kg (6.9%) at 12 months. The prevalence of short sleep duration (<6 h) or poor sleep quality did not change (p ≥ .45). By 12 months, those with baseline short sleep duration lost 4.5 ± 1.3% less weight than normal-duration sleepers (p < .001) and those with poor sleep quality lost 2.2 ± 1.2% less weight than good-quality sleepers (p = .04); those with both short sleep and poor sleep quality lost ≥ 5.0% less weight than all other groups (p < .001). Baseline short sleep was associated with lower attendance (-2.0 ± 0.8 sessions; p < .01); short sleep and poor quality were each associated with smaller increases in physical activity (-5.6 ± 2.4 and -7.8 ± 2.2 MET-h/wk, respectively; p < .02).

Baseline short sleep duration and poor sleep quality independently and jointly predicted poorer weight loss and lower adherence in a behavioral weight loss intervention. Screening for sleep disturbance may identify individuals who could benefit from additional support to improve adherence and outcomes.