Impact of Sleep and Sleep Loss on Glucose Homeostasis and Appetite Regulation

Abstract

SynopsisOver the past 30 years there has been an increase in the prevalence of obesity and diabetes, both of which can have serious consequences for longevity and quality of life. Sleep durations may have also decreased over this time period. This chapter reviews laboratory and epidemiologic evidence for an association between sleep loss and impairments in glucose metabolism and appetite regulation, which could increase the risk of diabetes or weight gain. Keywordssleep; appetite; diabetes; obesity; ghrelin; leptin IntroductionDiabetes and obesity are two debilitating chronic diseases that are increasing at an alarming rate worldwide [1,2]. Voluntary sleep restriction may play a role in the rapid increase in the prevalence of diabetes and obesity, and this chapter will review the evidence for such a link. Sleep restriction or impaired sleep may be more common in modern society than in past decades [3,4]. A survey study from 1960 found modal sleep duration to be 8.0 to 8.9 hours [5], while another survey study in 1995 observed a modal category of only 7 hours [6]. Recent national data also indicate that a greater percentage of adult Americans report sleeping 6 hours or less in 2004 than in 1985 [7]. Thus, the increase in the prevalence of obesity and diabetes appears to be mirrored by a decrease in average sleep duration in the U.S.In simplistic terms, weight gain occurs when there is positive energy balance, that is, energy intake is greater than energy expenditure (see Figure 1). Sleep restriction could affect endogenous processes related to energy balance, such as impairments in glucose metabolism and an upregulation of appetite. Sleep restriction could also affect exogenous factors such as food choice and increased time available to eat. Sleep loss could also lead to reductions in physical activity or energy expenditure, but evidence in support of this hypothesis is lacking. Both impaired glucose metabolism and excess weight can increase the risk of developing type 2 diabetes. Thus, this chapter will first review laboratory studies that examine the effects of sleep loss on glucose metabolism and appetite regulation. The chapter will then review the epidemiological evidence for an association between sleep restriction and diabetes risk, increased body mass index and risk of obesity.Corresponding Author: Kristen L Knutson, Department of Health Studies, University of Chicago, 5841 S. Maryland Avenue MC 2007, Chicago, IL 60637, Tel: 773-834-1973, Fax: 773-702-1979.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Sleep disordered breathing is a common sleep disorder th...

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