Magazine article Clinical Psychiatry News

Sleep Loss Tied to Impaired Glucose Tolerance

Magazine article Clinical Psychiatry News

Sleep Loss Tied to Impaired Glucose Tolerance

Article excerpt

RANCHO MIRAGE, CALIF. -- Healthy young adults who are chronic "short sleepers"--getting an average of about 5 hours of sleep a night--must secrete 30% more insulin than other adults to achieve a normal glucose curve.

The finding, which points to a potentially important connection between sleep, diabetes risk, and obesity, was just one of a series of observations made during detailed sleep studies conducted at the University of Chicago in recent years and presented by Eve Van Cauter, Ph.D., a professor of medicine at the university.

Sleep deprivation leads to decreased levels of the satiety hormone leptin, increases in the hunger hormone ghrelin, and impaired glucose tolerance, Dr. Van Cauter and associates discovered when they created a "sleep debt" in healthy adults by restricting the number of hours they slept, she said at a conference on sleep in infancy and childhood sponsored by the Annenberg Center for Health Sciences.

"In 1 week of sleep restriction, we brought volunteers to a prediabetic state. That was kind of a frightening thought," she said in describing one of her early studies into the metabolic and endocrine consequences of too little sleep (Lancet 1999;354:1435-9).

One of the first consequences of sleep-lessness is appetite dysregulation, the study showed. "Essentially, the accelerator for hunger [ghrelin] was pushed and the brake for satiety [leptin] was released," she explained. "The leptin levels are screaming 'More food! More food!'"

Sleep-deprived volunteers--even those receiving consistent and adequate amounts of energy via intravenous glucose--become famished, particularly craving high-carbohydrate foods such as candy, cookies, potato chips, and pasta.

"We have two studies suggesting that if you have a sleep debt, you might be less able to control hunger," she said at the meeting.

To study glucose tolerance and sleep, Dr. Van Cauter and her associates recently recruited 44 lean, healthy young adults, half of whom were chronic short sleepers who averaged 5 hours, 16 minutes of sleep a night, and half of whom averaged 7 hours, 52 minutes of sleep per night. The subjects were stratified by diabetes risk according to their ethnicity and family history of the disease. …

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