Reduced Sleep Duration or Quality: Relationships With Insulin Resistance and Type 2 Diabetes
Section snippets
Epidemiologic Studies Linking Sleep Loss to Diabetes
Several population studies, originating from different geographical locations and involving diverse subject populations, investigated the association between sleep and type 2 diabetes mellitus. In all of these studies, the information on sleep duration and/or quality was obtained from self-reported measures; thus, an important limitation is the lack of objective assessments of sleep. Multivariate statistical models were used in nearly all these studies in an attempt to control for a variety of
Impact of Reduced Sleep Duration
Over the past 4 decades, a few isolated studies from independent laboratories showed that acute total sleep deprivation is associated with glucose intolerance and insulin resistance.30, 31, 32, 33 Total sleep deprivation is necessarily a short-term condition, and the associated metabolic alterations are promptly corrected by sleep recovery. It is only recently that the adverse metabolic effects of chronic partial sleep deprivation, a much more commonly experienced condition in the general
Studies Linking OSA to Insulin Resistance and Diabetes
A new report by the International Diabetes Federation highlighted the need for a better understanding of the links between sleep apnea and type 2 diabetes mellitus.24 Recent data indicate that OSA is highly prevalent in patients with type 2 diabetes mellitus.77, 78, 79 Conversely, studies also suggest that disorders of glucose metabolism are more prevalent in patients with OSA. A comprehensive review of the literature on the link between OSA and alterations in glucose metabolism is beyond the
Conclusions
The research reviewed in this article suggests that sleep loss or disturbances may be novel risk factors for the development of type 2 diabetes mellitus. The adverse impact of reduced sleep duration and quality on glucose tolerance, demonstrated in laboratory studies, is consistent with the prospective epidemiologic evidence, suggesting an increased incidence of diabetes in people reporting short sleep and/or poor sleep quality. Current data also support an independent link between sleep apnea,
Acknowledgments
Supported by grants from NIH R01-HL086459 and Pfizer/AASM Scholars Grant in Sleep Medicine.
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Sleep, Health, and Society
2022, Sleep Medicine ClinicsCitation Excerpt :A recent meta-analysis showed that insufficient sleep is associated with a 33% increased risk of incident diabetes.52 These studies are supported by laboratory findings that show that physiologic sleep loss is associated with diabetes risk factors, including insulin resistance,53–56 and other diabetes risk factors, such as increased consumption of unhealthy foods.57–59 Physiologic studies also show that sleep loss can influence metabolism through changes in metabolic hormones,60,61 adipocyte function,62 and beta-cell function.63
Sleep, Health, and Society
2020, Sleep Medicine Clinics