Experimental Changes in Children's Sleep Duration and Timing: Effect on Obesity and Type 2 Diabetes Risk

Eligible families who provide consent/assent will be enrolled into a five week study. All
families will complete assessments at baseline, two weeks and four weeks. Each assessment
lasts one week and children will be asked to wear an actigraph on their wrist (to measure
sleep) and an accelerometer on their hip (to measure physical activity). At the end of the
week families will be scheduled for a visit at the research center first thing in the morning
approximately one hour after waking and following an overnight fast. During this visit,
actigraphs and accelerometers will be downloaded and data will be reviewed with families.
Children will be weighed and measured for height and have their body composition assessed. To
measure glucose regulation, children will first have 5 ml of blood drawn in a fasted state.
They will then ingest a glucose solution (1.75 g/kg; maximum of 75 g) over 2 minutes, and
blood will be drawn (1.5 ml) 120 min after the child consumes the solution. At week 4, 5 ml
blood will be drawn fasting; OGTT will not be administered (see note below). Research staff
will also complete one-day dietary recalls with participants at each center-based assessment
to obtain information on all foods consumed over the previous 24-hour period. In addition, at
the baseline assessment only, parents will complete questionnaires on basic demographic
information and child sleep. It is anticipated that the total time for each assessment will
take approximately 2.5-3 hours (1 hour at 4 weeks). Following eligibility confirmation at the
baseline assessment, families will be randomized to one of four protocols: 1) Enhance TIB by
90 min/night; 2) Enhance TIB by 45 min/night; 3) Regularize Sleep Schedule; or 4) Typical
Sleep Schedule.

Continuous glucose monitoring In a voluntary subset of randomly selected children
(approximately n = 4/group) 72-hour continuous glucose monitoring (CGM) will be performed. If
the child and family agree to participate in CGM, they will come to the Center for an
additional visit during which a disposable subcutaneous glucose-sensing device connected to a
battery-operated recorder will be inserted subcutaneously (a thin tube under the surface of
the skin). This sensor measures glucose every ten seconds and records an average value every
five minutes.

Inclusion Criteria:

1. Parent-reported child race African American/Black.

2. Parent-reported child age of 8-11 years

3. Less than or equal to approximately 9.5 hours time in bed (TIB; based on actigraphy
and sleep diaries)

4. Variability in Sleep Patterns (based on actigraphy and sleep diaries)

5. BMI for age and gender > 85th percentile (but no greater than 100% overweight)

6. Self-reported parent age of 18 years, primary caretaker, and at home throughout the
study (i.e., at bedtimes and wake times)

7. Reported willingness to complete all study tasks, including blood draws

Exclusion Criteria:

1. Diagnosable Sleep Disorder

2. Parent-reported diagnosis of medical or psychiatric condition that may impact
sleep/weight status

3. Actively trying to lose weight

4. Inability to Understand or Complete Protocol

5. Sibling of enrolled subjects