Sleep Deprivation Increases Risk of Insulin Resistance and Diabetes in Teens

by Dr Sam Girgis on October 1, 2012

Diabetes is a growing problem in the United States and throughout the world.  The incidence of diabetes is expected to continue to grow at an alarming rate in the future.  One factor that is fueling the growing type 2 diabetes incidence is the obesity epidemic.  We have previously discussed the association between sleep deprivation and poor diet choices and obesity.  Sleep deprivation in adult is also known to contribute to insulin resistance and type 2 diabetes.  There is accumulating evidence that sleep deprivation leads to weight gain and obesity in adolescents as well.  In addition, it has recently been found that sleep deprivation in adolescents leads to insulin resistance and diabetes.

Researchers, led by Dr. Karen Matthews from the University of Pittsburgh, have found that sleep deprivation in teenagers increases insulin resistance and can lead to diabetes.  The results of their research were published online in the journal Sleep.  The researchers conducted a cross sectional community based study involving 245 children aged 14 to 19 years.  The study participants provided fasting blood draws, kept sleep logs, and wore wrist actigraphs for one week during the school year.  Insulin resistance was assessed by homeostatic model assessment of insulin resistance (HOMA-IR).  The researchers found that shorter sleep duration was associated with increased insulin resistance even after adjusting for age, race, gender, body mass index, and waist circumference.

The authors wrote, “This study showed that higher insulin resistance is associated with shorter sleep duration assessed by actigraphy or diary among black and white healthy adolescents. These associations were independent of race, age, gender, waist circumference, and body mass index, and were obtained for measures of weekday sleep, not weekend sleep… To our knowledge, our study is the only one in healthy adolescents that shows a relationship between shorter sleep and insulin resistance that is independent of adiposity”.

The authors also wrote, “…multiple mechanisms may be important to explain the association between short sleep and increased insulin resistance. One pathway may be through sleep and/or circadian disruptions of the hormones that regulate food intake, i.e., leptin, an appetite-suppressing hormone, and ghrelin, an appetite stimulating hormone…Another potential pathway is through the autonomic nervous system, with sympathetic activation inhibiting and parasympathetic activation stimulating insulin release. Sleep loss may lead to lowered parasympathetic activity at night, allowing enhanced cardiac sympathetic activity.   Sleep loss also results in increased evening cortisol, which is associated with hyperinsulinemia, especially in conjunction with central adiposity.  Sleep loss can lead to insulin resistance through dysregulation of adipokines, independent of obesity”.

In an accompanying editorial, it was commented “…the results of Matthews et al. suggest that the relationship between short sleep duration and alterations in glucose homeostasis, which has been extensively demonstrated in adults in both epidemiologic and laboratory-based studies, is also present in adolescents. Given the potentially negative impact these alterations could have in the future metabolic and cardiovascular health of adolescents, it is clear that there is a need for controlled clinical trials to assess the impact of sleep extension and improved sleep hygiene on glucose metabolism in this vulnerable age group”.

The following study provides evidence that sleep deprivation not only contributes to obesity, but it also contributes to insulin resistance and diabetes in adolescents.  The authors give several possible mechanisms for this finding but these mechanisms need to be further investigated in the future.  In addition, future studies should assess whether obtaining proper sleep lengths help improve insulin resistance in teenagers.  The teenage years are critical for several reasons, and they establish the foundation for lifelong health patterns.  We should encourage our children to obtain the recommended 9 hours of sleep in order to prevent obesity and the occurrence of insulin resistance and diabetes.

 

Reference:

Karen A. Matthews et al. “Sleep Duration and Insulin Resistance in Healthy Black and White AdolescentsSleep 2012; 35(10):1353-1358 doi.org/10.5665/sleep.2112

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