Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain
Open accessAbstract
Insufficient sleep is associated with obesity, yet little is known about how repeated nights of insufficient sleep influence energy expenditure and balance. We studied 16 adults in a 14- to 15-d-long inpatient study and quantified effects of 5 d of insufficient sleep, equivalent to a work week, on energy expenditure and energy intake compared with adequate sleep. We found that insufficient sleep increased total daily energy expenditure by ∼5%; however, energy intake—especially at night after dinner—was in excess of energy needed to maintain energy balance. Insufficient sleep led to 0.82 ± 0.47 kg (±SD) weight gain despite changes in hunger and satiety hormones ghrelin and leptin, and peptide YY, which signaled excess energy stores. Insufficient sleep delayed circadian melatonin phase and also led to an earlier circadian phase of wake time. Sex differences showed women, not men, maintained weight during adequate sleep, whereas insufficient sleep reduced dietary restraint and led to weight gain in women. Our findings suggest that increased food intake during insufficient sleep is a physiological adaptation to provide energy needed to sustain additional wakefulness; yet when food is easily accessible, intake surpasses that needed. We also found that transitioning from an insufficient to adequate/recovery sleep schedule decreased energy intake, especially of fats and carbohydrates, and led to −0.03 ± 0.50 kg weight loss. These findings provide evidence that sleep plays a key role in energy metabolism. Importantly, they demonstrate physiological and behavioral mechanisms by which insufficient sleep may contribute to overweight and obesity.
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Sleep restriction generally increases 24-hour energy intake relative to habitual sleep, with overeating ranging from about 180 to 559 kcal per day.
“In general, studies reported increases in 24-hour energy intake when participants underwent sleep restriction relative to habitual sleep (Table 1), with the degree of overeating ranging from ≈180 to 559 kcal/d.”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [59]
When 24-hour energy expenditure was measured in a metabolic chamber, energy expenditure was increased with sleep restriction relative to habitual sleep.
“However, when 24-hour energy expenditure was measured in a metabolic chamber, which provides a more confined environment, energy expenditure was increased with sleep restriction relative to habitual sleep.59,82,83”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [59]
Markwald et al. reported increased 24-h leptin levels following sleep restriction that were accompanied by both greater caloric intake and significant weight gain.
“Indeed, Markwald et al. reported increased 24-h leptin levels following sleep restriction that were accompanied by both greater caloric intake and significant weight gain.75”
From The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review (2024) · cites this paper as [75]
Subsequent studies have found mixed results regarding leptin, with some showing elevations as opposed to decreases in leptin levels following sleep restriction and others showing no changes.
“Subsequent studies have found mixed results regarding leptin, with some showing elevations as opposed to decreases in leptin levels following sleep restriction [74][75][76][77] and others showing no changes.77,78”
From The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review (2024) · cites this paper as [75]
Markwald et al. reported that 5 days of insufficient sleep led to a significant 0.82 kg increase in body weight in a clinical, experimental study.
“In support of these epidemiological data, Markwald et al. reported that 5 days of insufficient sleep led to a significant 0.82 kg increase in body weight in a clinical, experimental study.75”
From The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review (2024) · cites this paper as [75]
Humans under sleep restriction eat more calories.
“In contrast, humans undergoing sleep restriction increase caloric intake (1, 2, 36-38) and show alterations in energy expenditure (39)(40)(41).”
From Oxalic acid and diacylglycerol 36:3 are cross-species markers of sleep debt (2015) · cites this paper as [2]
The dampening of the cortisol rhythm after 2 nights of sleep loss is consistent with recent studies that have shown that lack of sleep alters the phase and the amplitude of circadian-driven rhythms.
“The dampening of the cortisol rhythm after 2 nights of sleep loss is consistent with recent studies that have shown that lack of sleep alters the phase and the amplitude of circadian-driven rhythms (40, 41).”
From Adverse effects of two nights of sleep restriction on the hypothalamic-pituitary-adrenal axis in healthy men (2014) · cites this paper as [40]
Five hours in bed per night for 5 days showed an increase in 24-h energy expenditure (+5%, p<0.01) when compared with 9 hours in bed per night for 5 days.
“In one study of 5 hours in bed per night for 5 days, showed an increase in 24-h EE (+5%, p<0.01) when compared with 9 hours in bed per night for 5 days [41].”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [41]
The effects of sleep restriction on leptin levels in subsequent studies have been mixed, with some studies reporting an increase and others reporting no significant difference after sleep restriction.
“The effects of sleep restriction on leptin levels in subsequent studies have been mixed, with some studies reporting an increase in leptin [25, 41–45] while others reported no significant difference [33, 46–51] after sleep restriction.”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [41]
Although changes in hormone levels promoted satiety and reduced hunger, there was a significant increase in overall food intake promoting overeating in that study.
“Although the changes in hormone levels promoted satiety and reduced hunger, there was a significant increase in overall food intake promoting overeating in this study.”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [41]
In that study, a parallel increase in food intake (+6%, p<0.05) was observed, and post-dinner snacking increased with a greater preference for carbohydrates.
“A parallel increase in food intake (+6%, p<0.05) was observed. Post-dinner snacking increased with a greater preference for carbohydrates.”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [41]
Participants had an overall positive energy balance with an average yet statistically insignificant increase in weight gain in the 5-h per night sleep condition.
“The study participants had an overall positive energy balance with an average yet statistically insignificant increase in weight gain in the 5-h per night sleep condition.”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [41]
In 16 healthy normal-weight adults (8 men and 8 women), 24-h ghrelin levels decreased after a night of partial sleep deprivation (5 hours in bed) compared to baseline (−30%, p<0.001), while 24-h leptin levels increased (+22%, p<0.05) under the same conditions.
“On the contrary, in a study of 16 healthy normal-weight adults (8 men and 8 women), 24-h ghrelin levels decreased after a night of PSD (5 hours in bed) in comparison to baseline (−30%, p<0.001), while the 24-h leptin levels increased (+22%, p<0.05) under the same conditions [41].”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [41]
Sleep restriction to 4 h TIB for 3 nights vs 9 h TIB increases insulin resistance as estimated by HOMA-IR by 65% in adolescent boys.
“A study conducted in adolescent boys showed that sleep restriction to 4 h TIB for 3 nights vs. 9 h TIB increased insulin resistance as estimated by HOMA-IR by 65% [36]*.”
From Metabolic effects of sleep disruption, links to obesity and diabetes (2014) · cites this paper as [36]
The alteration in food desire observed here, coinciding with changes in brain activity, is consistent with previous behavioral findings describing increases in actual caloric intake following sleep loss when ad libitum food conditions are presented and increased cravings for higher caloric food categories.
“the alteration in food desire observed here, coinciding with changes in brain activity, are consistent with previous behavioral findings describing increases in actual caloric intake following sleep loss when ad libitum food conditions are presented3,22 and increased cravings for higher caloric food categories (e.g. sweet, salty and starchy foods)23.”
From The impact of sleep deprivation on food desire in the human brain (2013) · cites this paper as [22]
In that recent study, the increase in calorie intake resulted in significant gains in weight.
“Moreover, this increase in calorie intake resulted in significant gains in weight.”
From The impact of sleep deprivation on food desire in the human brain (2013) · cites this paper as [22]
Recent behavioral studies indicate that the largest impact of sleep loss on altered food choices occurs during the evening.
“recent behavioral studies indicate that the largest impact of sleep loss on altered food choices occurs during the evening22,30”
From The impact of sleep deprivation on food desire in the human brain (2013) · cites this paper as [22]
A recent study which assessed ad libitum caloric intake as well as energy expenditure in sleep-restricted humans reported increased calorie consumption beyond that which could be explained by expended energy or altered metabolic rate.
“a recent study which assessed ad libitum caloric intake as well as energy expenditure in sleep-restricted humans reported increased calorie consumption beyond that which could be explained by expended energy or altered metabolic rate22.”
From The impact of sleep deprivation on food desire in the human brain (2013) · cites this paper as [22]
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“Sleep and circadian rhythms are highly integrated such that sleep loss can occur with circadian misalignment and studies of sleep restriction have shown evidence for altered circadian timing [33, 34].”
Duration, timing and quality of sleep are each vital for health, performance and safety
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- Authors
- Markwald, R. R., Melanson, E. L., Smith, M. R., Higgins, J., Perreault, L., Eckel, R. H., & Wright, K. P.
- Affiliations
- University of Colorado Boulder (US)
- Division of Endocrinology, Metabolism, and Diabetes,
- University of Colorado Anschutz (US)
- ORCID
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2013-03-11
- Volume
- 110
- Issue
- 14
- Pages
- 5695-5700
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC3619301
- OpenAlex
- W2099096099
- Cited by
- 810
- References
- 50
- Citations by year
- 2026: 31 · 2025: 51 · 2024: 39 · 2023: 55 · 2022: 68 · 2021: 77 · 2020: 65 · 2019: 63 · 2018: 76 · 2017: 60 · 2016: 88 · 2015: 53 · 2014: 60 · 2013: 23
- FWCI
- 40.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Howard Hughes Medical Institute
- National Institutes of Health (UL1TR000154, UL1TR001082, TR000154)
- Directorate for Biological Sciences
- National Heart, Lung, and Blood Institute (R01HL109706)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK048520)
- National Center for Advancing Translational Sciences
- Colorado Clinical and Translational Sciences Institute (UL1 TR000154, TR000154)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- insufficient sleep, total energy expenditure, dietary intake, weight gain, obesity, energy balance, ghrelin, leptin, peptide YY, circadian rhythm, melatonin, sex differences, dietary restraint, sleep deprivation, energy metabolism
- MeSH terms
- Adult, Analysis of Variance, Calorimetry, Circadian Rhythm, Eating, Energy Metabolism, Female, Humans, Male, Oxygen Consumption, Sleep Deprivation, Weight Gain
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