Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions - PubMed (original) (raw)

Multicenter Study

. 2022 Feb;65(2):356-365.

doi: 10.1007/s00125-021-05608-y. Epub 2021 Nov 30.

Raphael Vallat 2, Juan Fernandez-Tajes 1, Linda M Delahanty 3, Jose M Ordovas 4 5, David A Drew 6 7, Ana M Valdes 8, Nicola Segata 9 10, Andrew T Chan 6 7, Jonathan Wolf 11, Sarah E Berry 12, Matthew P Walker 2, Timothy D Spector 13, Paul W Franks 14 15

Affiliations

Multicenter Study

Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions

Neli Tsereteli et al. Diabetologia. 2022 Feb.

Abstract

Aims/hypothesis: Sleep, diet and exercise are fundamental to metabolic homeostasis. In this secondary analysis of a repeated measures, nutritional intervention study, we tested whether an individual's sleep quality, duration and timing impact glycaemic response to a breakfast meal the following morning.

Methods: Healthy adults' data (N = 953 [41% twins]) were analysed from the PREDICT dietary intervention trial. Participants consumed isoenergetic standardised meals over 2 weeks in the clinic and at home. Actigraphy was used to assess sleep variables (duration, efficiency, timing) and continuous glucose monitors were used to measure glycaemic variation (>8000 meals).

Results: Sleep variables were significantly associated with postprandial glycaemic control (2 h incremental AUC), at both between- and within-person levels. Sleep period time interacted with meal type, with a smaller effect of poor sleep on postprandial blood glucose levels when high-carbohydrate (low fat/protein) (pinteraction = 0.02) and high-fat (pinteraction = 0.03) breakfasts were consumed compared with a reference 75 g OGTT. Within-person sleep period time had a similar interaction (high carbohydrate: pinteraction = 0.001, high fat: pinteraction = 0.02). Within- and between-person sleep efficiency were significantly associated with lower postprandial blood glucose levels irrespective of meal type (both p < 0.03). Later sleep midpoint (time deviation from midnight) was found to be significantly associated with higher postprandial glucose, in both between-person and within-person comparisons (p = 0.035 and p = 0.051, respectively).

Conclusions/interpretation: Poor sleep efficiency and later bedtime routines are associated with more pronounced postprandial glycaemic responses to breakfast the following morning. A person's deviation from their usual sleep pattern was also associated with poorer postprandial glycaemic control. These findings underscore sleep as a modifiable, non-pharmacological therapeutic target for the optimal regulation of human metabolic health. Trial registration ClinicalTrials.gov NCT03479866.

Keywords: Diet; Metabolic health; Person-centring; Postprandial glucose; Sleep.

© 2021. The Author(s).

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Figures

Fig. 1

Fig. 1

(a) Glucose 2 h iAUC distribution by test meal type. Box plot shows median and IQR; whiskers represent IQR and outliers (>1.5 × IQR) are shown. (b) Nutritional composition by test meal type. The iAUC data has also been published in [26]

Fig. 2

Fig. 2

Meal type and SPT interaction effects on glucose 2 h iAUC. The plot fits the model using the marginal effects of the interaction terms with the standard errors. MCM, metabolic challenge meal

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