Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA.
Diabetes. 2010 Sep;59(9):2126-33. doi: 10.2337/db09-0699. Epub 2010 Jun 28.
Short sleep duration is associated with impaired glucose tolerance and an increased risk of diabetes. The effects of sleep restriction on insulin sensitivity have not been established. This study tests the hypothesis that decreasing nighttime sleep duration reduces insulin sensitivity and assesses the effects of a drug, modafinil, that increases alertness during wakefulness.
This 12-day inpatient General Clinical Research Center study included 20 healthy men (age 20-35 years and BMI 20-30 kg/m(2)). Subjects spent 10 h/night in bed for >or=8 nights including three inpatient nights (sleep-replete condition), followed by 5 h/night in bed for 7 nights (sleep-restricted condition). Subjects received 300 mg/day modafinil or placebo during sleep restriction. Diet and activity were controlled. On the last 2 days of each condition, we assessed glucose metabolism by intravenous glucose tolerance test (IVGTT) and euglycemic-hyperinsulinemic clamp. Salivary cortisol, 24-h urinary catecholamines, and neurobehavioral performance were measured.
IVGTT-derived insulin sensitivity was reduced by (means +/- SD) 20 +/- 24% after sleep restriction (P = 0.001), without significant alterations in the insulin secretory response. Similarly, insulin sensitivity assessed by clamp was reduced by 11 +/- 5.5% (P < 0.04) after sleep restriction. Glucose tolerance and the disposition index were reduced by sleep restriction. These outcomes were not affected by modafinil treatment. Changes in insulin sensitivity did not correlate with changes in salivary cortisol (increase of 51 +/- 8% with sleep restriction, P < 0.02), urinary catecholamines, or slow wave sleep.
Sleep restriction (5 h/night) for 1 week significantly reduces insulin sensitivity, raising concerns about effects of chronic insufficient sleep on disease processes associated with insulin resistance.
睡眠不足与葡萄糖耐量受损和糖尿病风险增加有关。睡眠限制对胰岛素敏感性的影响尚未确定。本研究检验了这样一个假设，即减少夜间睡眠时间会降低胰岛素敏感性，并评估了一种名为莫达非尼的药物在清醒时提高警觉性的效果。
这是一项为期 12 天的住院综合临床研究中心的研究，共纳入 20 名健康男性（年龄 20-35 岁，BMI 20-30kg/m²）。受试者每晚在床上睡眠时间为 10 小时/晚，至少 8 晚，包括 3 个住院晚（睡眠充足条件），然后在 7 晚内每晚在床上睡眠时间为 5 小时/晚（睡眠限制条件）。在睡眠限制期间，受试者每天接受 300mg 莫达非尼或安慰剂治疗。饮食和活动受到控制。在每个条件的最后 2 天，我们通过静脉葡萄糖耐量试验（IVGTT）和正葡萄糖高胰岛素钳夹评估葡萄糖代谢。测量唾液皮质醇、24 小时尿儿茶酚胺和神经行为表现。
睡眠限制后（平均 +/- 标准差），IVGTT 衍生的胰岛素敏感性降低 20 +/- 24%（P = 0.001），胰岛素分泌反应无明显变化。同样，通过钳夹评估的胰岛素敏感性也降低了 11 +/- 5.5%（P < 0.04）。睡眠限制后葡萄糖耐量和胰岛素分泌指数降低。这些结果不受莫达非尼治疗的影响。胰岛素敏感性的变化与唾液皮质醇（睡眠限制时增加 51 +/- 8%，P < 0.02）、尿儿茶酚胺或慢波睡眠无关。
1 周的睡眠限制（每晚 5 小时）显著降低了胰岛素敏感性，这让人担忧与胰岛素抵抗相关的疾病过程中，慢性睡眠不足的影响。
