Sleep Deprivation Affects Insulin Sensitivity

Adolescents who sleep less than eight hours a night are likely to have fat around the waist and decreases in insulin sensitivity, according to a new study.

Sleep deprivation could lead to insulin resistance because of a dysregulation of appetite, leading to weight gain, and eventually result in type 2 diabetes mellitus.

Studies in adults have shown a relationship between sleep deprivation and increased cardiovascular risk factors, including increased prevalence of obesity and diabetes.

Brazilian researchers, led by senior author Bruno Geloneze, MD, PhD, of the Laboratory of Investigation on Metabolism and Diabetes at the University of Campinas in Sao Paolo, Brazil, investigated the association between sleep deprivation and insulin sensitivity, using data collected between 2011 and 2014 from 615 adolescents, ages 10 to 19, with a median age of 16 years.

Self-reported sleep duration was used to classify the population into two groups: adolescents with sleep deprivation (less than eight hours per night) and adolescents with adequate sleep (eight or more hours per night).

The researchers measured weight, height, and blood pressure, among other metrics. Insulin sensitivity was assessed in 81 adolescents who underwent the hyperglycemic clamp technique, a two-hour insulin sensitivity test.

On average, the teens reported sleeping 7.9 hours per night.

The 257 adolescents with sleep deprivation compared with the 358 with adequate sleep had a higher median age (17 vs 14.1 years), body mass index (BMI) (25 vs 23.1), waist circumference (83 vs 79), sagittal abdominal diameter (17.9 vs 17 cm), neck circumference (35.2 vs 33 cm), uric acid level (4.9 vs 4.5 mg/dL), and white blood cell count (7000 vs 6600 cells/μL). All of these values represent statistically significant differences.

“Moreover, the adolescents with sleep deprivation had a lower median insulin sensitivity index compared with those with adequate sleep. After controlling for age and sex in the multivariate regression model, sleep deprivation remained an independent predictor for those variables. In the sleep deprivation group, BMI and central distribution of fat were higher in all categories of adiposity,” the researchers stated.

The results suggest that an increase in insulin resistance independently of the presence of obesity is derived from an intrinsic mechanism connecting sleep deprivation and metabolic derangement.

A chronic reduction of two hours of sleep a day is enough to decrease insulin sensitivity, they noted.

Other research suggests that insulin resistance derives from an activation of stress-response pathways that antagonize the action of insulin.

The researchers concluded that “investigations of sleep duration and sleep quality in adolescents should be included in clinical practice to promote, through health education, the eradication of the health risks associated with sleep restriction.”

Reference: De Bernardi Rodrigues AM. Association of sleep deprivation with reduction in insulin sensitivity as assessed by the hyperglycemic clamp technique in adolescents. 21 Mar 2016.