Sleep disturbances and insulin resistance

Abstract

The causes and risk factors of insulin resistance remain insufficiently understood. After taking into account the important roles of adiposity, age, sex and race/ethnicity, up to 50% of the individual variability in insulin resistance remains unexplained. In recent years, evidence has accumulated to support a role for sleep disturbances, including insufficient sleep, poor sleep quality and insomnia, and obstructive sleep apnoea, as independent risk factors for the development and exacerbation of insulin resistance. The present review summarizes the evidence. We will start with a brief introduction to sleep and its disorders and then examine in succession the role of the three major types of sleep disturbances of modern society, namely insufficient sleep, poor sleep quality and/or insomnia and obstructive sleep apnoea. Insulin resistance is a hallmark of the polycystic ovary syndrome, the most common endocrine pathology in women, and the last section of this review will discuss the role of obstructive sleep apnoea in the insulin resistance and metabolic disturbances of polycystic ovary syndrome.

Nutritional Modulators of Sleep Disorders

“…The mechanism underlying early-onset diabetes was due to accelerated loss of beta-cell function and loss of beta-cell mass attributed to increases in beta-cell apoptosis. Disruption of circadian rhythms may increase the risk of diabetes by accelerating the loss of beta-cell function leading to insulin resistance which is characteristic in type to diabetes and CVDs [9,13].…”

“…In order to further clarify the underlying mechanisms, more and better high quality studies about this subject are necessary [15]. Obesity is a potential risk factor for diabetes mellitus therefore sleep disturbance due to shift work can also predispose type 2 diabetes [9][10][11][12][13]. (A longitudinal study was carried out on a day-shift work group (n = 3203) and alternating-shift work group (n = 2426) of a steel company in Japan who received their annual health checkups over a 10-year period between 1991 and 2001 (9).…”

“…These rhythms appear to have independent influence on the function of the endocrine system, circadian brain function and gastrointestinal tract [2-6, 8, 9, 11-15]. Insufficient sleep and its poor quality due to shift work interfere with beta cells functioning resulting in to risk factors for the development and exacerbation of insulin resistance [9][10][11][12][13]16]. Sleep disorders may cause increases in appetite, polyphasia leading to adiposity [8,15].…”

“…Apart from these factors, diet and lifestyle factors of the populations and other characteristics of the workplace where they work and live, such as work design, organization, management, and their societal contexts appear to be important in the pathogenesis of NCDs [1][2][3][4][5]. In this connection, shift work altering the circadian rhythm of sleep, appears to be an important occupational factor that has potential health implications [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Shift work indicating disturbance in sleep rhythm, can be classified in one of two ways.…”

“…In permanent, the work pattern may be constant but occupy unusual hours of the day. In developed countries, around one-fifth of workers may have irregular working schedules which may have adverse effects on sleep, resulting in to NCDs [2][3][4][5][6][7][8][9][10][11][12][13][14][15].…”