We examined satiety quotient (SQ) and energy intake (EI) according to sleep duration, quality and timing. Seventy-five overweight/obese men (age: 41.1±5.8 years; body mass index: 33.6±2.9 kg/m2) completed visual analogue scales for appetite sensations before, immediately after and every 10 minutes for 1 hour following a standardized breakfast. The mean SQ (primary outcome of the study) was calculated from four appetite sensations. The Pittsburgh Sleep Quality Index identified short-duration (<7 h/night) and ‘recommended sleep duration’ (⩾7 h/night) sleepers, poor (score ⩾5)- and good (score <5)-quality sleepers and late (midpoint of sleep >0230 hours) and early (midpoint of sleep ⩽0230 hours) sleepers. A 3-day food record and buffet-style meal assessed the EI. Short-duration sleepers had a lower mean SQ compared with recommended sleep duration sleepers (6.5±4.9 vs 8.8±4.3 mm/100 kcal; P=0.04). The mean SQ between poor and good (6.9±4.6 vs 8.7±4.6 mm/100 kcal; P=0.11) and that between early and late (8.99±5.10 vs 9.32±4.02 mm/100 kcal; P=0.78) sleepers were not significantly different. EI did not differ between the sleep groups. Thus, short-duration sleepers had a lower mean SQ compared with recommended sleep duration sleepers. However, this did not coincide with an increased EI.
Current evidence associates short sleep duration with the development of obesity.1 The satiety quotient (SQ), expressed according to energy intake (EI), determines the extent to which a meal can reduce subjective appetite sensations.2 A lower fullness SQ, or smaller changes in subjective fullness ratings in response to a meal, was associated with an increased EI in obese individuals.2 It is, however, unknown whether changes in SQ may differ according to sleep parameters.
The present study evaluated the SQ in response to a standardized meal in overweight/obese men according to sleep duration, sleep quality and sleep timing. The mean SQ, based on responses to four different appetite sensations, was the main outcome of this study. We hypothesized that a short sleep duration, poor sleep quality and a later bedtime would be associated with a lower mean SQ and a greater EI.
Seventy-five overweight/obese, healthy Caucasian men completed an in-laboratory assessment at Laval University (Quebec, Canada). The inclusion criteria were as follows: age between 30 and 50 years, body mass index between 28 and 40 kg/m2, non-smokers, not taking medications that could influence appetite, non-diabetic with no insulin treatment, weight stable (±4 kg within the past 2 months), <3 × 30 min/week of physical activity and a low dietary restraint (score <10 on the Three-Factor Eating Questionnaire). This study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures were approved by the Laval University ethics committee. Participants provided written informed consent.
Procedure and measurements
Participants arrived at the laboratory at 0800 hours following a 12-h overnight fast. They were instructed not to consume alcohol or engage in structured physical activity (for example, playing sports) for at least 24 h before testing and to follow their usual sleeping habits the previous night. Upon arrival, height, weight and waist circumference were measured according to standardized procedures3, and fat mass was measured by dual-energy X-ray absorptiometry (GE Medical Systems Lunar, Diegem, Belgium).
A standardized breakfast and ad libitum lunch were served at 0830 and 1200 hours, respectively. The compositions of these meals are described in more detail in Appendix. The breakfast had a food quotient (global indicator of meal macronutrient composition) of 0.85 and was entirely consumed within 20 minutes. The participants’ appetite sensations were recorded using visual analogue scales (VAS) before, immediately after, and at every 10 minutes for 1 hour following breakfast consumption. The 150-mm VAS were used to answer four questions that quantify subjective appetite sensations: desire to eat, hunger, fullness and prospective food consumption. The SQ was calculated for each appetite sensation using the following equation (2):
It is important to note that the SQ calculation for fullness is reversed (the mean post meal rating−fasting rating). The mean SQ represents the mean value of the four individual SQ scores. This was selected as the primary outcome of the study as it provides a composite indication of the changes in appetite sensations in response to the meal. A lower SQ indicates a weaker satiety response to a meal.3
The Pittsburgh Sleep Quality Index4 determined sleep duration (self-reported item), sleep quality (total score) and sleep timing (midpoint of sleep based on reported wake time and sleep duration) over the last month. The calculations for sleep timing are described elsewhere.5
Three-day food records and physical activity diaries, including 2 weekdays and one weekend day, assessed habitual EI and moderate-to-vigorous physical activity participation, respectively, following the in-laboratory assessment.
Independent t-tests compared variables between the sleep duration, sleep quality and sleep timing groups. Statistical significance was set at P<0.05. Statistical analyses were performed using JMP (version 10; SAS Institute, Cary, NC).
Table 1 presents participants’ characteristics according to sleep groups. There were no differences in these variables between groups, except for 3-day carbohydrate intake between sleep quality groups (P=0.03). There were no significant differences in specific SQ for desire to eat, hunger, fullness or prospective food consumption between groups (data not shown). Short-duration sleepers had a lower mean SQ compared to sleepers with recommended sleep durations, whereas no significant differences in the mean SQ between sleep quality and sleep timing groups were noted (Figure 1).
To our knowledge, this is the first study to examine measures of SQ according to sleep duration, sleep quality and sleep timing in overweight/obese men. Short sleep duration was associated with a weaker mean SQ, despite no significant differences in body weight, fat mass and EI between sleep duration groups. There were no differences in the mean SQ between sleep quality and sleep timing groups, despite a greater 3-day carbohydrate intake in good vs poor sleepers. The SQ is a more valid indicator of potential changes in subjective appetite ratings in response to a standardized meal compared with 1 h post-prandial area under the curve calculations because it considers pre-meal appetite sensations and meal caloric content.3
The greater mean SQ in short-duration sleepers did not coincide with greater EI in this study. These results suggest that appetite ratings may not be consistently related to measured or reported EI.6 Furthermore, despite noting a greater EI following imposed sleep restrictions,7, 8 one study found no differences in appetite ratings between sleep conditions,7 whereas another only noted increased pre-prandial hunger ratings following sleep restriction.8 Taken together, changes in appetite ratings, or SQ, may not be consistently related to changes in EI and vice versa.
Studies have also shown that a later sleep timing may lead to an increase in EI after 2000 hours,9 as well as a greater total EI5 in adults and obese children/adolescents, respectively. Conversely, the current study did not observe a significant difference in the mean SQ and EI between sleep timing groups. This lack of association may be due to differences in participant characteristics and calculated sleep timing midpoints between this study and others.5, 9
Finally, reductions in stage 2, rapid eye movement and slow-wave sleep were associated with greater hunger ratings and EI,10 whereas the occurrence of sleep fragmentation led to a lower fullness and greater desire to eat ratings compared with a non-fragmented sleep condition.11 These results suggest that alterations in specific sleep stages following imposed sleep fragmentation, rather than self-reported habitual sleep quality, may alter appetite ratings.
The present findings are limited to a small sample size of overweight/obese men, which limits generalizability to other populations. The cross-sectional design used does not allow for causal relationships to be drawn. Finally, the use of self-reported measurements and the possibility of residual confounding factors cannot be overlooked (for example, we are unable to determine whether differences in sleep timing are related to biological predispositions or social circumstances).
Although exploratory, we observed a lower mean SQ in short-duration sleepers. The mean SQ between sleep quality and sleep timing groups was not statistically different. Finally, no difference in EI was noted between sleep groups. Future studies are needed to confirm these preliminary findings.
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VD and AT conceived and carried out the experiment. JM, JPC, VD and ARG analysed the data. All authors were involved in writing the paper and had final approval of the submitted and published versions. This study was partly funded by the Canadian Institutes of Health Research. ARG is funded by the Quebec Heart and Lung Research Institute. JPC holds a Junior Research Chair in Healthy Active Living and Obesity Research. AT holds a Canada Research Chair in Environment and Energy Balance.
The authors declare no conflict of interest.
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Cite this article
McNeil, J., Drapeau, V., Gallant, A. et al. Short sleep duration is associated with a lower mean satiety quotient in overweight and obese men. Eur J Clin Nutr 67, 1328–1330 (2013). https://doi.org/10.1038/ejcn.2013.204
- satiety quotient
- sleep duration
- sleep quality
- sleep timing
- energy intake
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