Abstract
Driven by the demands and opportunities of modern life many people now sleep less than 6 hrs per night. In the sleep clinic, this behavior may present as a diagnosis of insufficient sleep syndrome (ICSD-9, #307.49-4) which is receiving increased attention as a potential risk factor for obesity and related metabolic morbidity. A central theme of this chapter is the notion that extended wakefulness has higher metabolic cost, which triggers a set of neuroendocrine (e.g. more hunger and less satiety), metabolic (e.g. lower resting metabolic rate), and behavioral (e.g. reduced daily activity) adaptations aimed at increasing food intake and conserving energy. Although this coordinated response may have evolved to offset the metabolic demands of sleeplessness in natural habitats with limited food availability, it can become maladaptive in a modern environment which allows many to overeat while maintaining a sedentary lifestyle without sufficient sleep. Growing experimental evidence now suggests that such sleep-loss-related metabolic adaptation could: (a) lead to increased retention of fat when people aim to return to their usual weight after various life events associated with excessive food intake; and (b) undermine the success of therapies combining reduced food intake and increased physical activity to decrease metabolic risk in obesity-prone individuals. Emerging observational and clinical trial data are consistent with this experimental framework, making it prudent to recommend that overweight and obese individuals attempting to reduce their caloric intake and maintain increased physical activity should obtain adequate sleep and seek effective treatment for any coexisting sleep disorders.
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Summary points
Summary points
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Mammalian evolution has established reciprocal connections between sleep and energy homeostasis.
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Driven by the demands and opportunities of modern life many people sleep less than 6Â hrs a night. Such short sleep has been associated with increased risk of obesity.
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Extended wakefulness has higher metabolic cost which leads to compensatory neuroendocrine, metabolic, and behavioral changes to stimulate food intake and conserve energy. These changes share principal similarities with the pattern of human metabolic adaptation to negative energy balance.
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Although this response may have evolved to offset the metabolic cost of extended wakefulness in habitats with limited food availability, it can become maladaptive in a modern environment which allows many to overeat while maintaining a sedentary lifestyle without sufficient sleep.
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Sleep-loss-induced metabolic adaptation can: (a) lead to increased retention of fat when people aim to return to their usual weight after life events associated with excessive food intake; and (b) undermine the success of behavioral interventions involving decreased food intake and increased physical activity to reduce metabolic risk in obesity-prone individuals.
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Overweight and obese individuals attempting to reduce their caloric intake and maintain increased physical activity should obtain adequate sleep.
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Penev, P.D. (2013). Sleep deprivation and human energy metabolism. In: Preedy, V.R., Patel, V.B., Le, LA. (eds) Handbook of nutrition, diet and sleep. Human Health Handbooks, vol 3. Wageningen Academic Publishers, Wageningen. https://doi.org/10.3920/978-90-8686-763-9_13
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DOI: https://doi.org/10.3920/978-90-8686-763-9_13
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