Negative Effects of Time in Bed Extension: A Pilot Study.

Epidemiologic studies have consistently shown an association of long sleep (≥8 hr) with mortality and multiple morbidities. However, there has been little experimental investigation of the effects of sleep extension. The aim of this study was to examine the effects of time in bed (TIB) extension, on depression, anxiety, sleepiness, and systemic inflammation. Following baseline, 14 healthy sleepers (31.79±10.94 years) were randomized to one of two one-week treatments: (1) a TIB extension treatment involving a fixed sleep schedule in which TIB was increased by 3 hours/night compared with the participants' median baseline TIB; (2) a control treatment involving a fixed schedule in which TIB was the same as the participants' median baseline TIB. Actigraphic recording of sleep was assessed throughout both weeks. Self-reported depression, state anxiety, sleepiness, and sleep quality, as well as blood pressure, and inflammation were assessed at baseline and following the treatment week. Compared with baseline, TIB increased by 127.12±3.92 min and total sleep time increased by 119.88±18.52 min during TIB extension, but decreased slightly in the control treatment. Depression was elevated more following TIB extension (effect size (ES)=-0.86) vs. control (ES=-0.50). Interleukin-6 levels increased by 2-fold following TIB extension (ES=-0.65), but did not change following the control treatment. Sleepiness increased after TIB extension, but decreased after the control treatment. The results revealed negative effects of TIB extension on mood and inflammation. Larger-scale studies involving more prolonged, but less profound sleep extension, are warranted.

[1]  A. Beck,et al.  Beck Depression Inventory–II , 2011 .

[2]  C. Spielberger State‐Trait Anxiety Inventory , 2010 .

[3]  J. Stradling,et al.  Health status in obstructive sleep apnea: relationship with sleep fragmentation and daytine sleepiness, and effects of continuous positive airway pressure treatment. , 1999, American journal of respiratory and critical care medicine.

[4]  J. Taub,et al.  Effects of ad lib extended-delayed sleep on sensorimotor performance, memory and sleepiness in the young adult , 1980, Physiology & Behavior.

[5]  Daniel J Buysse,et al.  The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research , 1989, Psychiatry Research.

[6]  J. Croft,et al.  Habitual sleep patterns and risk for stroke and coronary heart disease , 1997, Neurology.

[7]  R. Bootzin,et al.  Chronic moderate sleep restriction in older long sleepers and older average duration sleepers: a randomized controlled trial. , 2013, Contemporary clinical trials.

[8]  Richard Lipton,et al.  The Relation Between Cognitive Functioning and Self-Reported Sleep Complaints in Nondemented Older Adults: Results From the Bronx Aging Study , 2007, Behavioral sleep medicine.

[9]  K. Kayaba,et al.  Sleep Duration and Mortality in Japan: the Jichi Medical School Cohort Study , 2004, Journal of epidemiology.

[10]  K. Spiegel,et al.  Impact of sleep debt on metabolic and endocrine function , 1999, The Lancet.

[11]  E. Stepanski,et al.  The effect of sleep fragmentation on daytime function. , 2002, Sleep.

[12]  S. Redline,et al.  Sleep duration and biomarkers of inflammation. , 2009, Sleep.

[13]  S. Ancoli-Israel,et al.  Sleep characteristics of self-reported long sleepers. , 2012, Sleep.

[14]  Yu-Hsuan Lin,et al.  Nighttime sleep, Chinese afternoon nap, and mortality in the elderly. , 2007, Sleep.

[15]  S. Ratcliffe,et al.  Development of the FOSQ-10: a short version of the Functional Outcomes of Sleep Questionnaire. , 2009, Sleep.

[16]  J. Hardin,et al.  Tolerance of chronic 90-minute time-in-bed restriction in older long sleepers. , 2009, Sleep.

[17]  M. Johns,et al.  A new method for measuring daytime sleepiness: the Epworth sleepiness scale. , 1991, Sleep.

[18]  A. Tamakoshi,et al.  Self-reported sleep duration as a predictor of all-cause mortality: results from the JACC study, Japan. , 2004, Sleep.

[19]  R. Berger,et al.  Performance and mood following variations in the length and timing of sleep. , 1973, Psychophysiology.

[20]  D. Kripke,et al.  No effect of 8‐week time in bed restriction on glucose tolerance in older long sleepers , 2008, Journal of sleep research.

[21]  D. Schade,et al.  Impaired orthostatic response in patients with type 2 diabetes mellitus after 48 hours of bed rest. , 2009, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[22]  W. Dwyer,et al.  Sleep compression and sleep education for older insomniacs: self-help versus therapist guidance. , 1995, Psychology and aging.

[23]  H. Kohl,et al.  Sedentary behavior, physical activity, and the metabolic syndrome among U.S. adults. , 2005, Obesity research.

[24]  Eberhard Schulz,et al.  Physical Inactivity Rapidly Induces Insulin Resistance and Microvascular Dysfunction in Healthy Volunteers , 2007, Arteriosclerosis, thrombosis, and vascular biology.

[25]  G. Globus A Syndrome Associated with Sleeping Late , 1969, Psychosomatic medicine.

[26]  G. Jean-Louis,et al.  Associations between inadequate sleep and obesity in the US adult population: analysis of the national health interview survey (1977–2009) , 2014, BMC Public Health.

[27]  D. Kripke,et al.  Mortality associated with sleep duration and insomnia. , 2002, Archives of general psychiatry.

[28]  Daniel J Buysse,et al.  Protecting sleep quality in later life: a pilot study of bed restriction and sleep hygiene. , 2001, The journals of gerontology. Series B, Psychological sciences and social sciences.

[29]  F. Hu,et al.  Correlates of long sleep duration. , 2006, Sleep.

[30]  Atul Malhotra,et al.  A prospective study of sleep duration and coronary heart disease in women. , 2003, Archives of internal medicine.

[31]  J. Manson,et al.  A prospective study of self-reported sleep duration and incident diabetes in women. , 2003, Diabetes care.

[32]  Martin J Shipley,et al.  Change in sleep duration and cognitive function: findings from the Whitehall II Study. , 2011, Sleep.

[33]  T. Lam,et al.  Short or long sleep duration is associated with memory impairment in older Chinese: the Guangzhou Biobank Cohort Study. , 2011, Sleep.

[34]  M. Sallinen,et al.  Self‐reported sleep duration and cognitive functioning in the general population , 2009, Journal of sleep research.

[35]  Sati Mazumdar,et al.  Protecting Sleep, Promoting Health in Later Life: A Randomized Clinical Trial , 2010, Psychosomatic medicine.

[36]  A. Vaag,et al.  Impact of Physical Inactivity on Adipose Tissue Low-Grade Inflammation in First-Degree Relatives of Type 2 Diabetic Patients , 2011, Diabetes Care.

[37]  Markku Partinen,et al.  Sleep and mortality: a population-based 22-year follow-up study. , 2007, Sleep.

[38]  David P White,et al.  A prospective study of sleep duration and mortality risk in women. , 2004, Sleep.

[39]  D. Kripke,et al.  Long sleep and mortality: rationale for sleep restriction. , 2004, Sleep medicine reviews.

[40]  T. Young,et al.  Short Sleep Duration Is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index , 2004, PLoS medicine.