Alternate Day Fasting Combined With a Low Carbohydrate Diet: Effect on Sleep Quality, Duration, Insomnia Severity and Risk of Obstructive Sleep Apnea in Adults With Obesity
Abstract Objectives Alternate day fasting combined with a low carbohydrate diet (ADF-LC) is an effective weight loss regimen. Whether the weight loss induced by ADF-LC can improve sleep remains unknown. This study examined an ADF-LC diet's effect on sleep quality, duration, insomnia severity, and the risk of obstructive sleep apnea. Methods Adults with obesity (n = 31) participated in ADF (600 kcal “fast day”; ad libitum intake “feast day”) with a low-carbohydrate diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight-loss period followed by a 3-month weight maintenance period. Results Reductions in body weight (−5 ± 1 kg, P < 0.001) and fat mass (−4 ± 1 kg, P < 0.01) were noted during the weight-loss period, and these reductions were sustained during the weight maintenance period. Lean mass and visceral fat remained unchanged. The Pittsburgh Sleep Quality Index (PSQI) score indicated poor sleep quality at baseline (6.4 ± 0.7) with no change by month 3 or 6, versus baseline. ISI score indicated subthreshold insomnia at baseline (8.5 ± 1.0), with no change by month 3 or 6, versus baseline. The % of subjects with a high risk of obstructive sleep apnea was 45% at baseline, with no change by month 3 or 6. Wake time, bedtime, and sleep duration remained unchanged. Conclusions The ADF-LC diet does not impact sleep quality, duration, insomnia severity, or the risk of obstructive sleep apnea in adults with obesity. Funding Sources Nestle Health Sciences.