LAUSR

Time-based interventions, such as time-limited eating (TLE), have become a promising dietary strategy in adults with obesity. TLE involves shortening the daily eating window to a pre-specified number of hours and fasting for the remaining hours of the day without altering diet quality. No study to date has examined the impact of TLE on sleep quality in adolescents with obesity. We conducted a secondary analysis of a 12-week pilot study that compared TLE (8-h eating window/16-h fasting window) to a prolonged window (12-h eating window/12-h fasting window) in adolescents with obesity (ages 14 to19, 72% female, 74% Hispanic). All youth completed the Pittsburgh Sleep Quality Index (PSQI) at baseline (n = 42), weeks 4 (n = 43), and 12 (n = 42). The seven component PSQI score, develops a global score that ranges from 0 to 21, where higher scores indicates worse sleep. Glycemic profiles were captured via continuous glucose monitors (CGM) worn for the duration of the study. Mixed effects generalized linear model in log scale and ordinal logistic regression models were utilized to (a) examine the change in PSQI total score and (b) assess the association between glycemic variability and PSQI total score overtime by intervention arm. Across all youth included in this analysis (n = 43), there was improvement in PSQI total score at week 12 compared to baseline that was marginally significant after adjusting for multiple testing (% change = -19.60, 95%CI = -31.83 to -5.18, p = 0.057). The median PSQI score for the TLE group (n = 29) was 6 at week 0 (5 to10) and 5 at week 12 (2.5 to 7), suggesting sleep quality improved. The changes in PSQI total score, sleep ratio, and sleep onset score over the course of study were not statistically different between groups (p > 0.05). There was no significant association between glycemic variability and PSQI score between the groups. Findings from this secondary analysis indicate that TLE does not negatively alter sleep quality or duration in adolescents with obesity. The potential effects of TLE on sleep should be further investigated in larger randomized trials.