Study Title:

Inuslin Resistance and a Short Night's Sleep

Study Abstract

Background: Subsequent nights with partial sleep restriction result in impaired glucose tolerance, but the effects on insulin sensitivity have not been characterized.

Objective: The aim of this study was to evaluate the effect of a single night of partial sleep restriction on parameters of insulin sensitivity.

Research Design and Methods: Nine healthy subjects (five men, four women) were studied once after a night of normal sleep duration (sleep allowed from 2300 to 0730 h), and once after a night of 4 h of sleep (sleep allowed from 0100 to 0500 h). Sleep characteristics were assessed by polysomnography. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp studies (from 1130 to 1430 h) with infusion of [6,6-2H2]glucose.

Results: Sleep duration was shorter in the night with sleep restriction than in the unrestricted night (226 ± 11 vs. 454 ± 9 min; P< 0.0001). Sleep restriction did not affect basal levels of glucose, nonesterified fatty acids, insulin, or endogenous glucose production. Sleep restriction resulted in increased endogenous glucose production during the hyperinsulinemic clamp study compared to the unrestricted night (4.4 ± 0.3 vs. 3.6 ± 0.2 μmolxkg lean body mass-1 · min-1; P = 0.017), indicating hepatic insulin resistance. In addition, sleep restriction decreased the glucose disposal rate during the clamp (32.5 ± 3.6 vs. 40.7 ± 5.1 μmol · kg lean body mass-1 · min-1; P = 0009), reflecting decreased peripheral insulin sensitivity. Accordingly, sleep restriction decreased the rate of glucose infusion by approximately 25% (P = 0.001). Sleep restriction increased plasma nonesterified fatty acid levels during the clamp study (68 ± 5 vs. 57 ± 4 μmol/liter; P = 0.005).

Conclusions: Partial sleep deprivation during only a single night induces insulin resistance in multiple metabolic pathways in healthy subjects. This physiological observation may be of relevance for variations in glucoregulation in patients with type 1 and type 2 diabetes.

From press release:

According to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM), just one night of short sleep duration can induce insulin resistance, a component of type 2 diabetes.

"Sleep duration has shortened considerably in western societies in the past decade and simultaneously, there has been an increase in the prevalence of insulin resistance and type 2 diabetes," said Esther Donga, MD of the Leiden University Medical Center in The Netherlands and lead author of the study. "The co-occurring rises in shortened sleep and diabetes prevalence may not be a coincidence. Our findings show a short night of sleep has more profound effects on metabolic regulation than previously appreciated."

Previous studies have found that reductions in sleep duration over multiple nights result in impaired glucose tolerance, but this is the first study to examine the effects of only a single night of partial sleep restriction on insulin sensitivity.

In this study, researchers examined nine healthy subjects, once after a night of normal sleep duration (approximately eight hours), and once after a night of four hours of sleep. Insulin sensitivity of each study participant was measured using the hyperinsulinemic euglycemic clamp method. This method uses catheters to infuse glucose and insulin into the bloodstream and then determines insulin sensitivity by measuring the amount of glucose necessary to compensate for an increased insulin level without causing hypoglycemia.

"Our data indicate that insulin sensitivity is not fixed in healthy subjects, but depends on the duration of sleep in the preceding night," said Donga. "In fact it is tempting to speculate that the negative effects of multiple nights of shortened sleep on glucose tolerance can be reproduced, at least in part, by just one sleepless night."

Donga adds that further studies are needed to evaluate whether interventions aimed at improving sleep duration may be beneficial in stabilizing glucose levels in patients with diabetes.

Study Information

1.E. Donga, M. van Dijk, J. G. van Dijk, N. R. Biermasz, G. J. Lammers, K. W. van Kralingen, E. P. M. Corssmit, J. A. Romijn
A Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects
Journal of Clinical Endocrinology & Metabolism,
2010 April
Leiden University Medical Center in The Netherlands

Full Study