Chronic Insufficient Sleep in Women Impairs Insulin Sensitivity Independent of Adiposity Changes: Results of a Randomized Trial
Year: 2023
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: OBJECTIVE: Insufficient sleep is associated with type 2 diabetes, yet the causal impact of chronic insufficient sleep on glucose metabolism in women is unknown. We investigated whether prolonged mild sleep restriction (SR), resembling real-world short sleep, impairs glucose metabolism in women. RESEARCH DESIGN AND METHODS: Women (aged 20-75 years) without cardiometabolic diseases and with actigraphy-confirmed habitual total sleep time (TST) of 7-9 h/night were recruited to participate in this randomized, crossover study with two 6-week phases: maintenance of adequate sleep (AS) and 1.5 h/night SR. Outcomes included plasma glucose and insulin levels, HOMA of insulin resistance (HOMA-IR) values based on fasting blood samples, as well as total area under the curve for glucose and insulin, the Matsuda index, and the disposition index from an oral glucose tolerance test. RESULTS: Our sample included 38 women (n = 11 postmenopausal women). Values are reported with ±SEM. Linear models adjusted for baseline outcome values demonstrated that TST was reduced by 1.34 ± 0.04 h/night with SR versus AS (P < 0.0001). Fasting insulin (β = 6.8 ± 2.8 pmol/L; P = 0.016) and HOMA-IR (β = 0.30 ± 0.12; P = 0.016) values were increased with SR versus AS, with effects on HOMA-IR more pronounced in postmenopausal women compared with premenopausal women (β = 0.45 ± 0.25 vs. β = 0.27 ± 0.13, respectively; P for interaction = 0.042). Change in adiposity did not mediate the effects of SR on glucose metabolism or change results in the full sample when included as a covariate. CONCLUSIONS: Curtailing sleep duration to 6.2 h/night, reflecting the median sleep duration of U.S. adults with short sleep, for 6 weeks impairs insulin sensitivity, independent of adiposity. Findings highlight insufficient sleep as a modifiable risk factor for insulin resistance in women to be targeted in diabetes prevention efforts.
Source: Diabetes Care
DOI: 10.2337/dc23-1156
Institution: Columbia University Irving Medical Center
Language: English
Topic: Sleep and related disorders
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Funders: American Heart Association, National Institutes of Health, Irving Medical Center, Columbia University, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences
Awards: TREAT (Time Restricted EATing) to improve cardiometabolic health, The Effects of Sleep Restriction on Endothelial Activation in Pre- and Post-Menopausal Women, G235420648, G266294490, Effect of long-term sleep restriction on energy balance, G3674725773, G3684647554, Impact of sleep restriction on cardiometabolic risk factors in pre- vs postmenopausal women, Obstructive Sleep Apnea and Subclinical Lung Injury in Health and Disease, G645702072, G707876124, Vascular Endothelial Activation in Sleep Apnea, Sleep stability, weight, and glycemic control, G9000090439, Clinical and Translational Science Award, Mechanisms addressing the causal relationships of sleep, circadian rhythms, and cardiometabolic health, Vascular endothelial dysfunction in sleep apnea, New York Obesity Research Center, Columbia Diabetes Research Center, Postdoctoral Training in Arteriosclerosis Research
OpenAlex ID: W4388627384