For a study, researchers included 810 overweight or obese individuals with baseline sleep disturbance assessments who were randomly assigned one of four diets varying in macronutrient composition to examine associations between sleep disturbance and changes in weight and body composition, as well as the mediating role of changes in appetite and food cravings in the Preventing Overweight Using Novel Dietary Strategies (POUNDS Lost) 2-year weight-loss diet intervention trial. 

During the 2-year intervention, DEXA and computed tomography were used to measure changes in body weight and fat distribution. Participants were asked at baseline to rate their sleep disturbances (none, slight, moderate, or severe) and to recall their sleep disturbances since their last visit at 6, 12, 18, and 24 months. The initial six months of weight loss were followed by 1.5 years of continuous weight increase. After multivariate correction, participants with higher sleep disruption from baseline to 6 months lost significantly more body weight (Ptrend < 0.001) and waist circumference (Ptrend = 0.002) at 6 months. In addition, individuals with slight, moderate, or great sleep disturbance from baseline to 6 months had an increased risk of failure to lose weight (5% or more loss) at 6 months when the maximum weight loss was achieved, with odds ratios of 1.24 (95% CI 0.87, 1.78), 1.27 (95% CI 0.75, 2.13), or 3.12 (95% CI 1.61, 6.03), respectively. 

Furthermore, they discovered that frequently assessed levels of sleep disruption during 2 years were negatively related to the total weight loss rate (weight changes per 6 months) (Ptrend <0.001). Furthermore, sleep disruptions during weight loss from baseline to 6 months and weight return from 6 months to 24 months strongly predicted changes in total fat, total fat mass percent, and trunk fat percent over the two years. Food cravings for carbohydrates/starches, fast food fats, and sweets; desires, prospective consumption, hunger and appetite measures; and dietary restriction, disinhibition, and hunger subscales tested at 6 months all substantially moderated the effects of sleep disruption on weight loss.