Effects of Two-Week Sleep Extension on Glucose Metabolism in Chronically Sleep-Deprived Individuals

Abstract

Study Objectives: Sleep deprivation is known to be associated with insulin resistance and diabetes risk. This study investigated whether 2-week sleep extension in chronically sleep-deprived individuals would improve glucose metabolism. Methods: A crossover study was conducted in volunteers without diabetes who reported sleeping ≤ 6 h/night. They were randomized to maintain their habitual sleep or extend sleep time for 2 weeks, then crossed over after a washout period. Sleep was monitored by actigraphy. Oral glucose tolerance tests (75 g) with insulin levels was performed at the end of each period. Mixed-effect linear regression analysis, adjusting for sequence and period effects, was applied. Results: A total of 21 participants (19 females) with mean (standard deviation) age of 33.1 (6.1) years completed the protocol. Mean sleep duration during habitual sleep was 318.7 (44.3) minutes and the participants extended their sleep by 36.0 (45.2) minutes during sleep extension. The average washout period was 21 (11) days. There were no significant effects of sleep extension on any metabolic parameters. The per-protocol analysis included eight participants who could sleep more than 6 hours during sleep extension (mean sleep duration 396 [25] minutes, extended by 60.1 [28.5] minutes). Among these individuals, sleep extension improved Homeostatic Model Assessment of Insulin Resistance (adjusted mean difference −0.50 [95% confidence interval [CI] −0.89, −0.11, P = .013]), early insulin secretion (insulinogenic index; mean difference 0.39 [95% CI 0.15, 0.63, P = .001]), and β-cell function (disposition index, mean difference 1.07 [95% CI 0.17, 1.97, P = .02]). Conclusions: Sleep extension in chronically sleep-deprived individuals improved glucose metabolism in only those who could objectively extend their sleep to more than 6 h/night. Our findings suggest that a critical amount of sleep is needed to benefit metabolic outcomes.

Sleep Health: An Opportunity for Public Health to Address Health Equity

“…Building on the robust evidence linking sleep symptoms and disorders with CVD risk, intervention studies would provide the strongest demonstration of sleep as a causal risk factor. Such intervention-focused research ( 51 , 114 ), however, has lagged far behind the observational studies of sleep and CVD risk, and the limited data to date are inconclusive. For example, a large, randomized clinical trial found that CPAP (continuous positive airway pressure) treatment did not prevent CVD events among patients with prevalent CVD ( 92 ).…”

The influence of sleep health on dietary intake: a systematic review and meta‐analysis of intervention studies

“…Four studies included male participants exclusively (6,37,39,43) , four studies included only female participants (27,33,38,42) and 16 studies included both male and female participants (7)(8)(9)(10)(11)26,28,31,32,(34)(35)(36)40,41,44,45) . Body mass index (BMI) was reported in all 24 studies and mean BMI was <25 kg m -2 (normal BMI range) in 16 studies (6)(7)(8)11,31,32,34,35,37,(39)(40)(41)(42)(43)(44)(45) and >25 kg m -2 (overweight/ obese BMI range) in seven studies (9,10,26,28,33,36,38) . One study compared dietary outcomes in both healthy weight and overweight participants (27) , one study compared dietary outcomes by sex…”

“…Included studies were 11 randomised cross-over studies (6,9,11,28,33,36,37,(42)(43)(44)(45) , five non-randomised cross-over studies (8,27,35,39,40) , five RCTs (two-arm) (7,10,31,32,41) and three pre-post studies (26,34,38) . Of the 24 studies, 13 were conducted in a laboratory (6)(7)(8)(9)(10)(11)26,28,(31)(32)(33)36,37) , six in a free-living setting (27,34,38,41,42,45) and five in a mixed setting (35,39,40,43,44) . The studies conducted in a mixed setting were all cross-over studies where participants spent part of the experiment in a laboratory (i.e.…”

Associations of sleep quality, sleep apnea and autonomic function with insulin secretion and sensitivity: HSCAA study

“…However, no known previous study has objectively measured sleep duration and quality, and then examined their association with insulin secretion and sensitivity. Recently, So-Ngerm and colleagues conducted a clinical trial and objectively confirmed sleep extension shown by actigraphy is significantly associated with insulin secretion indices in sleep deprived healthy individuals [ 42 ], though the effects of changes in sleep quality were not analyzed. In the present study, we quantitatively determined sleep duration and quality using actigraphy results from a relatively large number of patients without diabetes under treatment, and show for the first time that sleep quality, though not sleep duration, is significantly associated with insulin secretion, but not with insulin sensitivity.…”