Even Small Sleep Debt Linked to Obesity, Insulin Resistance

By Lorraine L. Janeczko

NEW YORK - Losing sleep on weekdays is associated with both obesity and insulin resistance, possibly exacerbating the progression of type 2 diabetes, new research suggests.

"What was surprising was that just a small amount of sleep (debt) -- 30 minutes -- can increase the risk of these chronic diseases," lead author Dr. Teresa Arora, postdoctoral associate in medicine at Weill Cornell Medical College in Doha, Qatar, told Reuters Health by email.

"Our findings have important implications for patient care," she said. "Sleep is commonly disregarded by society and medical professionals. Our results show that educating newly diagnosed diabetes patients about the importance of sleep may help them with glucose control. Improving sleep is a cost-effective approach, which may help manage patients with diabetes."

The results were presented on March 7 at ENDO 2015, the annual meeting of the Endocrine Society, in San Diego, California.

For their study, Dr. Arora and her colleagues recruited 522 participants recently diagnosed with type 2 diabetes. The patients were between 30 and 80 years old and had a BMI above 25 kg/m2.

The participants in the Early Activity in Diabetes trial were randomized into one of three groups: usual care, physical activity intervention, or diet and physical activity intervention. They all completed a seven-day sleep diary and sleep questionnaire at baseline.

Patients who were in weekday sleep debt at baseline were significantly more likely to be obese compared with those who were not (odds ratio, 1.72).

After adjustment, weekday sleep debt was significantly associated with obesity (OR, 1.80) and insulin resistance determined by homeostasis model assessment of insulin resistance (OR, 2.04) at six months.

At 12 months the links were even stronger. For every 30 minutes of weekday sleep debt the patients had at baseline, their risk of obesity and insulin resistance increased by 17% and 39%, respectively.

The authors caution there could be several confounders.

"The next steps are to conduct a randomized controlled trial of improving sleep in early diabetes combined with other lifestyle interventions," co-author Dr. Shahrad Taheri, professor of medicine at Weill Cornell Medical College in Qatar, told Reuters Health by email.

"People don't take sleep seriously enough," Dr. Taheri said. "One of the reasons that lifestyle interventions for obesity and diabetes have not been as successful as we would like may be because we have ignored the effect of sleep. Clinicians need to consider sleep in the health of their patients and help them improve their sleep through behavior change."

Dr. Eve Van Cauter, director of the Sleep, Metabolism and Health Center of the University of Chicago, agreed.

"Trying to improve diabetes control or to lose weight in the presence of a large sleep debt is almost impossible," Dr. Van Cauter, who was not involved in the study, told Reuters Health by email. "Optimizing sleep amount and quality should be incorporated in lifestyle recommendations."

SOURCE: https://bit.ly/1LuXQm6

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