The metabolic consequences of sleep deprivation

Abstract

The prevalence of diabetes and obesity is increasing at an alarming rate worldwide, and the causes of this pandemic are not fully understood. Chronic sleep curtailment is a behavior that has developed over the past 2-3 decades. Laboratory and epidemiological studies suggest that sleep loss may play a role in the increased prevalence of diabetes and/or obesity. Current data suggest the relationship between sleep restriction, weight gain and diabetes risk may involve at least three pathways: (1) alterations in glucose metabolism; (2) upregulation of appetite; and (3) decreased energy expenditure. The present article reviews the current evidence in support of these three mechanisms that might link short sleep and increased obesity and diabetes risk.

Figure 1

Schematic of the potential pathways leading from sleep loss to diabetes risk.

Figure 2

Change in daytime levels of leptin, ghrelin, appetite and hunger from 10-hour to 4-hour bedtimes in 12 healthy lean subjects after 2 days of curtailed sleep . Hunger and appetite were measured on a visual analogue scale.

Figure 3

Schematic of positive energy balance in which energy intake is greater than energy expenditure which would result in weight gain. Numerous endogenous and exogenous factors can influence both sides of this balance, and sleep has been associated with both endogenous and exogenous factors.