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Clinical Question
Is chronic sleep loss may cause Type 2 diabetes mellitus?
Bottom Line
Chronic sleep loss, behavioral or sleep disorder related, may represent a
novel risk factor for weight gain, insulin resistance, and Type 2 diabetes.
Reference
Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes.
Spiegel K, Knutson K, Leproult R, Tasali E, Cauter EV.J Appl Physiol. 2005
Nov;99(5):2008-19.
Synopsis
Chronic sleep loss as a consequence of voluntary bedtime restriction is an
endemic condition in modern society. Although sleep exerts marked modulatory
effects on glucose metabolism, and molecular mechanisms for the interaction
between sleeping and feeding have been documented, the potential impact of
recurrent sleep curtailment on the risk for diabetes and obesity has only
recently been investigated. In laboratory studies of healthy young adults
submitted to recurrent partial sleep restriction, marked alterations in
glucose metabolism including decreased glucose tolerance and insulin
sensitivity have been demonstrated. The neuroendocrine regulation of
appetite was also affected as the levels of the anorexigenic hormone leptin
were decreased, whereas the levels of the orexigenic factor ghrelin were
increased. Importantly, these neuroendocrine abnormalities were correlated
with increased hunger and appetite, which may lead to overeating and weight
gain. Consistent with these laboratory findings, a growing body of
epidemiological evidence supports an association between short sleep
duration and the risk for obesity and diabetes. Chronic sleep loss may also
be the consequence of pathological conditions such as sleep-disordered
breathing. In this increasingly prevalent syndrome, a feedforward cascade of
negative events generated by sleep loss, sleep fragmentation, and hypoxia
are likely to exacerbate the severity of metabolic disturbances. |