Metabolic and Glycemic Sequelae of Sleep Disturbances in Children and Adults

Abstract

The prevalence of obesity in adults and children has increased greatly in the past three decades, as have metabolic sequelae, such as insulin resistance and type 2 diabetes mellitus (T2DM). Sleep disturbances are increasingly recognized as contributors to this widespread epidemic in adults, and data are emerging in children as well. The categories of sleep disturbances that contribute to obesity and its glycemic co-morbidities include the following: (1) alterations of sleep duration, chronic sleep restriction and excessive sleep; (2) alterations in sleep architecture; (3) sleep fragmentation; (4) circadian rhythm disorders and disruption (i.e., shift work); and (5) obstructive sleep apnea. This article reviews current evidence supporting the contributions that these sleep disorders play in the development of obesity, insulin resistance, and T2DM as well as possibly influences on glycemic control in type 1 diabetes, with a special focus on data in pediatric populations.

Microstructural abnormalities in white and gray matter in obese adolescents with and without type 2 diabetes

“…Although we did not monitor sleep apnea, it has been associated with obesity and type 2 diabetes in adolescents (Koren et al, 2015). …”

Sleep in adolescents and young adults with type 1 diabetes: associations with diabetes management and glycemic control

“…The measure has been shown to be associated with objective measures of sleep such as polysomnography, and has been used in studies with adolescents. 18 In order to assess the differential relation between diabetes outcomes and different aspects of sleep similar to what has been examined in adults with T1D, 5 we focused on the following subscales for the present study: sleep duration (hours/night), sleep disturbance (sum of 9 items, e.g., feel too hot, have bad dreams, on a scale of 0 (not during the last month) to 3 (three or more times a week), and sleep quality (perceived overall quality of sleep).…”

“…Sleep disturbances have recently gained attention as a potential risk factor for individuals with diabetes, 5 yet the associations between sleep and diabetes outcomes have not been well studied in adolescents and young adults with T1D. The recommended amount of sleep is 8–10 hours for adolescents, 6 but the majority of adolescents obtain insufficient sleep (defined as <8 hours/night).…”

Associations of sleep duration and quality with disinhibited eating behaviors in adolescent girls at-risk for type 2 diabetes

“…Shorter than recommended levels of sleep are associated with excessive gains in adiposity and exacerbated metabolic functioning among children (Cappuccio et al, 2008; Fatima, Doi, & Mamun, 2015; Hart et al, 2011; Koren, O'Sullivan, & Mokhlesi, 2015; Matthews & Pantesco, 2015). Prior data suggest that this association may be explained, in part, by disinhibited eating patterns (Beebe et al, 2013; Burt et al, 2014; Firouzi et al, 2014; Golley et al, 2013; Hart et al, 2013; Simon et al, 2015).…”

“…Although the generalizability of the current study’s findings are limited to adolescent girls at-risk for type 2 diabetes, little is known about the sleep and disinhibited eating behaviors of these individuals. Obesity (Park, Falconer, Viner, & Kinra, 2012), poor sleep (Flint et al, 2007; Koren et al, 2011; Koren et al, 2015; Matthews et al, 2012) and disinhibited eating (Tanofsky-Kraff et al, 2012) all increase risk for metabolic dysfunction and are thus important factors to consider concurrently when designing clinical efforts for the prevention of type 2 diabetes. Furthermore, the majority of prior studies examining sleep and eating behavior have relied on self-report methods of general energy intake and there has been little attention to specific disinhibited eating behaviors associated with excessive weight gain and exacerbated metabolic functioning in youth, such as binge eating (Field et al, 2003; Sonneville et al, 2013; Tanofsky-Kraff et al, 2006).…”