Metabolic Consequences of Sleep and Circadian Disorders
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Sleep and circadian rhythms modulate or control daily physiological patterns with importance for normal metabolic health. Sleep deficiencies associated with insufficient sleep schedules, insomnia with short-sleep duration, sleep apnea, narcolepsy, circadian misalignment, shift work, night eating syndrome, and sleep-related eating disorder may all contribute to metabolic dysregulation. Sleep deficiencies and circadian disruption associated with metabolic dysregulation may contribute to weight gain, obesity, and type 2 diabetes potentially by altering timing and amount of food intake, disrupting energy balance, inflammation, impairing glucose tolerance, and insulin sensitivity. Given the rapidly increasing prevalence of metabolic diseases, it is important to recognize the role of sleep and circadian disruption in the development, progression, and morbidity of metabolic disease. Some findings indicate sleep treatments and countermeasures improve metabolic health, but future clinical research investigating prevention and treatment of chronic metabolic disorders through treatment of sleep and circadian disruption is needed.
KeywordsSleep Circadian misalignment Insufficient sleep Sleep deficiency Insulin sensitivity Energy balance Shift work Type 2 diabetes Metabolic syndrome Obesity Glucose tolerance Circadian disruption Sleep apnea Circadian disorders Metabolic consequences
Kenneth P. Wright Jr. has received grant support from the NIH R01 HL109706, R21 DK092624.
Compliance with Ethics Guidelines
Conflict of Interest
Christopher M. Depner and Ellen R. Stothard declare that they have no conflict of interest. Kenneth P. Wright Jr. has been a Past Chair Scientific Advisory Board—fatigue and maritime work schedules for Northwestern University American Waterways Project; Past Chair Scientific Advisory Board—company developed sleep monitoring system for the general public for Zeo, Inc.; past consultant for Takeda Pharmaceuticals; has received honoraria from the University of Chicago and Associated Professional Sleep Societies; payment from Potomac Center for Medical Education for shift work sleep disorders in hospitals; and has received grant support for Philips, Inc.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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- 2.Sleep in America Poll. National Sleep Foundation. 2008.Google Scholar
- 4.•Markwald RR, Melanson EL, Smith MR, Higgins J, Perreault L, Eckel RH, et al. Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain. Proc Natl Acad Sci U S A. 2013;110:5695–700. This controlled laboratory study modeled a work week of insufficent sleep with ad-libitum feeding and measured 24 hour energy expenditure using whole room calorimetry. The findings indicate that insufficinet sleep contributes to weight gain via excessive food intale associated with incresed energy expoenditure. The findings also indicate potential benefit of recovery sleep. Google Scholar
- 5.Nguyen J, Wright Jr KP. Influence of weeks of circadian misalignment on leptin levels. Nat Sci Sleep. 2010;2009:9–18.Google Scholar
- 8.•Scheer FA, Hilton MF, Mantzoros CS, Shea SA. Adverse metabolic and cardiovascular consequences of circadian misalignment. Proc Natl Acad Sci U S A. 2009;106:4453–8. This study employs a circadian research protocol called forced desynchrony to disassociate sleep and circadian modulation of cardiometabolic measures.PubMedCentralPubMedCrossRefGoogle Scholar
- 9.Markwald RRWJ, Kenneth P. Circadian Misalignment and Sleep Disruption in Shift Work: Implications for Fatigue and Risk of Weight Gain and Obesity. In: Shiromani P, Horvath T, Redline S, Van Cauter E, editors. Sleep loss and obesity : intersecting epidemics. New York: Springer; 2012. p. 101–18.CrossRefGoogle Scholar
- 14.Sack RL, Auckley D, Auger RR, Carskadon MA, Wright Jr KP, Vitiello MV, et al. Circadian rhythm sleep disorders: part II, advanced sleep phase disorder, delayed sleep phase disorder, free-running disorder, and irregular sleep-wake rhythm. An American Academy of Sleep Medicine review. Sleep. 2007;30:1484–501.PubMedCentralPubMedGoogle Scholar
- 20.International Classification of Sleep Disorders, 3rd ed. American Academy of Sleep Medicine. 2014.Google Scholar
- 30.Nedeltcheva AV, Kessler L, Imperial J, Penev PD. Exposure to recurrent sleep restriction in the setting of high caloric intake and physical inactivity results in increased insulin resistance and reduced glucose tolerance. J Clin Endocrinol Metab. 2009;94:3242–50.PubMedCentralPubMedCrossRefGoogle Scholar
- 32.Leproult R, Holmback U, Van Cauter E. Circadian misalignment augments markers of insulin resistance and inflammation, independently of sleep loss. Diabetes. 2014. doi: 10.2337/db13-1546.
- 33.•Buxton OM, Cain SW, O'Connor SP, Porter JH, Duffy JF, Wang W, et al. Adverse metabolic consequences in humans of prolonged sleep restriction combined with circadian disruption. Sci Transl Med. 2012;4:129ra43. This study describes metabolic alterations in response to extended (3 weeks) sleep restriction combined with circadian misalignment, as well as subsequent recovery sleep. Google Scholar
- 47.•Vgontzas AN, Liao D, Pejovic S, Calhoun S, Karataraki M, Bixler EO. Insomnia with objective short sleep duration is associated with type 2 diabetes: a population-based study. Diabetes Care. 2009;32:980–5. Findings from this study provide the strongest evidence that there are differences between insomnia with short-sleep duration vs insomnia with normal sleep duration.CrossRefGoogle Scholar
- 49.Knutson KL, Van Cauter E, Zee P, Liu K, Lauderdale DS. Cross-sectional associations between measures of sleep and markers of glucose metabolism among subjects with and without diabetes: the Coronary Artery Risk Development in Young Adults (CARDIA) Sleep Study. Diabetes Care. 2011;34:1171–6.PubMedCentralPubMedCrossRefGoogle Scholar
- 52.Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;22:667–89.Google Scholar
- 57.Steiropoulos P, Papanas N, Nena E, Tsara V, Fitili C, Tzouvelekis A, et al. Markers of glycemic control and insulin resistance in non-diabetic patients with Obstructive Sleep Apnea Hypopnea Syndrome: does adherence to CPAP treatment improve glycemic control? Sleep Med. 2009;10:887–91.PubMedCrossRefGoogle Scholar
- 59.•Sharma SK, Agrawal S, Damodaran D, Sreenivas V, Kadhiravan T, Lakshmy R, et al. CPAP for the metabolic syndrome in patients with obstructive sleep apnea. N Engl J Med. 2011;365:2277–86. Findings that CPAP resolved MetS in 20 % of patients show strong potential benefit from CPAP. Future studies need to confirm and extend these initial findings to address critiques raised by some researchers.PubMedCrossRefGoogle Scholar
- 72.•Engel A, Helfrich J, Manderscheid N, Musholt PB, Forst T, Pfutzner A, et al. Investigation of insulin resistance in narcoleptic patients: dependent or independent of body mass index? Neuropsychiatr Dis Treat. 2011;7:351–6. Findings strengthened by use of BMI matched controls.PubMedCentralPubMedCrossRefGoogle Scholar
- 79.Painting, firefighting, and shiftwork. IARC Monogr Eval Carcinog Risks Hum. 2010;98:9–764.Google Scholar