Behavioural and Metabolic Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
Can J Diabetes. 2013 Apr;37(2):103-8. doi: 10.1016/j.jcjd.2013.02.060. Epub 2013 Apr 23.
Epidemiological studies suggest that adults and children who are habitual short sleepers tend to have a higher body mass index, fat percentage and abdominal circumference when compared to average-duration sleepers. Reduced or disturbed sleep is also associated with certain predictors of type 2 diabetes, such as glucose intolerance, insulin resistance, reduced insulin response to glucose and a reduction in the disposition index. Current experimental evidence suggests that sleep restriction may lead to increased food intake but does not appear to result in decreased energy expenditure. Furthermore, sleep restriction has been reported to increase evening cortisol levels, which may decrease insulin sensitivity the next morning. This notion was further supported by studies, which noted decreases in the effectiveness of insulin-mediated glucose uptake the following morning. Further evidence suggests that short sleepers have glucose responses that are similar to average-duration sleepers, but at the cost of an increase in insulin release, which may be the result of decreased insulin sensitivity over time. Recent studies also provide evidence that sleep restriction enhances susceptibility to food stimuli, especially for energy-dense, high-carbohydrate foods. In summary, inadequate sleep, in both quality and quantity, should be regarded as a plausible risk factor for the development of obesity and type 2 diabetes. In addition to other health promotion measures, a good night's sleep should be seen as a critical health component by clinicians in the prevention and treatment of obesity and type 2 diabetes.
流行病学研究表明，与睡眠时间正常的人相比，习惯性睡眠不足的成年人和儿童的体重指数、体脂百分比和腰围往往更高。睡眠减少或睡眠质量差也与 2 型糖尿病的某些预测因素有关，如葡萄糖耐量受损、胰岛素抵抗、胰岛素对葡萄糖的反应降低以及处置指数降低。目前的实验证据表明，睡眠限制可能导致食物摄入量增加，但似乎不会导致能量消耗减少。此外，有研究报告称，睡眠限制会导致傍晚皮质醇水平升高，这可能会降低第二天早上的胰岛素敏感性。这一观点得到了进一步研究的支持，这些研究指出，第二天早上胰岛素介导的葡萄糖摄取效率降低。进一步的证据表明，睡眠时间短的人葡萄糖反应与睡眠时间正常的人相似，但代价是胰岛素释放增加，这可能是随着时间的推移胰岛素敏感性降低的结果。最近的研究还提供了证据，表明睡眠限制会增加对食物刺激的敏感性，尤其是对能量密集、高碳水化合物的食物。总之，无论是在质量还是数量上，睡眠不足都应被视为肥胖和 2 型糖尿病发展的一个合理风险因素。除了其他促进健康的措施外，临床医生在预防和治疗肥胖症和 2 型糖尿病时，应将良好的睡眠视为一个关键的健康组成部分。
