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Open Access Highly Accessed Study protocol

Effects of exercise and diet interventions on obesity-related sleep disorders in men: study protocol for a randomized controlled trial

Xiao Tan1, Antti Saarinen2, Tuija M Mikkola1, Jarkko Tenhunen1, Samu Martinmäki1, Aki Rahikainen1, Shumei Cheng1, Niklas Eklund3, Satu Pekkala1, Petri Wiklund1, Eveliina Munukka1, Xinfei Wen1, Fengyu Cong4, Xi Wang5, Yajun Zhang5, Ina Tarkka1, Yining Sun5, Markku Partinen3, Markku Alen67 and Sulin Cheng15*

Author Affiliations

1 Department of Health Sciences, University of Jyväskylä, Rautpohjankatu 8, PO Box 35, 40700 Jyväskylä, Finland

2 Central Finland Central Hospital, Central Finland Health Care District, Keskussairaalantie 19, 40620 Jyväskylä, Finland

3 Helsinki Sleep Clinic, Vitalmed Research Center, Sitratori 3, Third floor, 00420 Helsinki, Finland

4 Department of Mathematical Information Technology, University of Jyväskylä, (Agora), PO Box 35, 40014 Jyväskylä, Finland

5 Institute of Intelligent Machines, Chinese Academy of Sciences, 350 Shushan Road, Hefei 230031, Anhui, People’s Republic of China

6 Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland

7 Institute of Health Sciences, University of Oulu, Kajaanintie 50, Oulu 90220, Finland

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Trials 2013, 14:235  doi:10.1186/1745-6215-14-235

Published: 26 July 2013

Abstract

Background

Sleep is essential for normal and healthy living. Lack of good quality sleep affects physical, mental and emotional functions. Currently, the treatments of obesity-related sleep disorders focus more on suppressing sleep-related symptoms pharmaceutically and are often accompanied by side effects. Thus, there is urgent need for alternative ways to combat chronic sleep disorders. This study will investigate underlying mechanisms of the effects of exercise and diet intervention on obesity-related sleep disorders, the role of gut microbiota in relation to poor quality of sleep and day-time sleepiness, as well as the levels of hormones responsible for sleep-wake cycle regulation.

Methods/design

Participants consist of 330 (target sample) Finnish men aged 30 to 65 years. Among them, we attempt to randomize 180 (target sample) with sleep disorders into exercise and diet intervention. After screening and physician examination, 101 men with sleep disorders are included and are randomly assigned into three groups: exercise (n = 33), diet (n = 35), and control (n = 33). In addition, we attempt to recruit a target number of 150 healthy men without sleep disorders as the reference group. The exercise group undergoes a six-month individualized progressive aerobic exercise program based on initial fitness level. The diet group follows a six month specific individualized diet program. The control group and reference group are asked to maintain their normal activity and diet during intervention. Measurements are taken before and after the intervention. Primary outcomes include objective sleep measurements by polysomnography and a home-based non-contact sleep monitoring system, and subjective sleep evaluation by questionnaires. Secondary outcome measures include anthropometry, body composition, fitness, sleep disorder-related lifestyle risk factors, composition of gut microbiota and adipose tissue metabolism, as well as specific hormone and neurotranmitter levels and inflammatory biomarkers from venous blood samples.

Discussion

It is expected that the improvement of sleep quality after exercise and diet intervention will be evident both in subjective and objective measures of quality of sleep. Additionally, the change of sleep quality induced by exercise and diet intervention is expected to be related to the changes in specific hormones and inflammatory biomarkers, and in the composition of gut microbiota.

Trial registration

Current Controlled Trials ISRCTN77172005

Keywords:
Lifestyle intervention; Sleep disorders; Quality of sleep; Obstructive sleep apnea; Insomnia; Sleep measurement; Obesity; Gut microbiota; Neurotransmitters