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Sleep Regularity and Cardiometabolic Heath: Is Variability in Sleep Patterns a Risk Factor for Excess Adiposity and Glycemic Dysregulation?
Open accessAbstract
Purpose of review Night-to-night variability in sleep patterns leads to circadian disruption and, consequently, could increase cardiometabolic risk. The purpose of this review is to summarize findings from studies published between 2015 and 2020 examining various measures of night-to-night variability in sleep in relation to metabolic syndrome (MetS), type 2 diabetes (T2D), and their risk factors. We illustrate a potential causal pathway between irregular sleep patterns and T2D, highlighting knowledge gaps along the way.Recent findings Across different measures of sleep variability, irregular sleep patterns were associated with poorer cardiometabolic outcomes. Higher standard deviations (SD) across nights of sleep duration and onset or midpoint of sleep were associated with increased odds of having MetS and clusters of metabolic abnormalities as well as greater adiposity and poorer glycemic control. Conversely, greater regularity of rest-activity patterns related to lower risk for T2D. Social jetlag was associated with glycemic dysregulation, adiposity, T2D, and MetS. These associations are often observed in both metabolically healthy and unhealthy individuals; both higher SD of sleep duration and social jetlag relate to poorer glucose regulation in individuals with diabetes. There is consistent evidence of associations of sleep variability with increased risk for adiposity, glucose dysregulation, T2D, and MetS. Although experimental evidence is needed to determine causation, there is support to recommend stabilizing sleep patterns for cardiometabolic risk prevention.
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Sleep disorders are common in type 2 diabetes.
“Sleep disorders are common in type 2 diabetes”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [114]
The “Circadian Rest-Activity Rhythms in T2D” section reports more variable and fragmented sleep and rest-activity patterns in a small group of patients with type 2 diabetes. It does not establish that diagnosed sleep disorders are common among people with type 2 diabetes; the authors say the finding needs confirmation in larger samples. No page number is available in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measuredSleep disorders cause disturbances in the quantity, quality, and timing of sleep.
“and cause disturbances in the quantity, quality, and timing of sleep”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [114]
The section on night-to-night variability reports that insomnia co-occurs with changes in sleep duration and timing. It does not establish that sleep disorders cause those changes, nor does it say that sleep disorders disturb sleep quality. Our copy provides no page numbers for these passages. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSleep disorders are associated with an increased risk of obesity and impairments in daytime functioning and glucose metabolism.
“and are associated with an increased risk of obesity and impairments in daytime functioning and glucose metabolism (114,115).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [114]
The section on night-to-night sleep variability and cardiometabolic health reports associations with obesity and high fasting glucose. The paper addresses irregular sleep patterns and insomnia, rather than sleep disorders generally, and the passages found do not support the claimed impairment in daytime functioning. (LLM, conf=0.86)
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Correlates of sleep variability in a mobile EEG-based volunteer study
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Alternatives to surgery in children with mild OSA
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Self-citationSocial Jetlag and Cardiometabolic Risk in Preadolescent Children
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Hayes, J. F., Schumacher, L. M., Lanoye, A. M., LaRose, J. G., Tate, D. F., Espeland, M. A., Gorin, A. A., Lewis, C. E., Jelalian, E., & Wing, R. R. (2022) · Journal of Behavioral Medicine · doi:10.1007/s10865-022-00339-w · Cited by 8
Consistency is key: sleep regularity predicts all-cause mortality
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Self-citationWake up! It's time to recognize the importance of sleep in metabolic health
Zuraikat, F. M., Jelić, S., & St‐Onge, M. (2023) · Obesity · doi:10.1002/oby.23776 · Cited by 6
Self-citationSleep and Anabolic/Catabolic Hormonal Profile in Sedentary Middle-Aged Adults: The FIT-AGEING Study
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Xia, Y. Q., He, S., Sun, Z., & Wang, F. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120481 · Cited by 6
Sleep regularity and mortality: a prospective analysis in the UK Biobank
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Kim, K. J., Lee, J.-B., Choi, J., Seo, J. Y., Yeom, J. W., Cho, C., Bae, J. H., Kim, S. G., Lee, H., & Kim, N. H. (2022) · Endocrinology and Metabolism · doi:10.3803/enm.2022.1479 · Cited by 7
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Fluctuations in Sleep Duration and Timing and Cardiometabolic Risk
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Self-citationPérez-Chada, D., & Gozal, D. (2022) · SLEEP · doi:10.1093/sleep/zsac300 · Cited by 5
An Update on Sleep Duration, Obesity, and Mortality Risk in Women
Full, K. M., Johnson, D. A., Kaufmann, C. N., & Malhotra, A. (2023) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2023.06.015 · Cited by 5
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The Updating and Individualizing of Sleep Hygiene Rules for Non-clinical Adult Populations
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A Triadic Pathway Model of Self-Compassion and Health
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Tackling Shift Work: Cardiovascular Health in the Auto Industry
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Sleep Regularity and Mortality: A Prospective Analysis in the UK BiobankPreprint
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Patterns of Sleep Duration and Metabolic Biomarkers Across the Menstrual Cycle
Dunietz, G. L., Shedden, K., Lyu, X., Chervin, R. D., Baylín, A., O'Brien, L. M., Jansen, E. C., Wactawski‐Wende, J., Schisterman, E. F., & Mumford, S. L. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae191 · Cited by 2
Islam, Z., Yamamoto, S., Konishi, M., Kochi, T., Kabe, I., & Mizoue, T. (2025) · Journal of Sleep Research · doi:10.1111/jsr.70064 · Cited by 2
Sleep Regularity and Mortality: A Prospective Analysis in the UK BiobankPreprint
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Gesunder Schlaf - gesunder Stoffwechsel
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Sleep Regularity and Mortality: A Prospective Analysis in the UK BiobankPreprint
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Defining Normal in Pediatric Sleep: Some Thoughts and Things to Think About
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Analysis of microcirculatory disorders in men with more than 10 years’ experience on night work
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Sleep in cardiovascular disease
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Metadata
- Authors
- Zuraikat, F. M., Makarem, N., Redline, S., Aggarwal, B., Jelic, S., & St-Onge, M.-P.
- Affiliations
- Columbia University Irving Medical Center (US)
- Brigham and Women's Hospital (US)
- Venue
- Current Diabetes Reports
- Published
- 2020-07-23
- Volume
- 20
- Issue
- 8
- Pages
- 38-38
- ISSN
- 1534-4827 (ISSN-L)
- 1539-0829
- PMC
- PMC7584347
- OpenAlex
- W3045418496
- Cited by
- 125
- References
- 47
- Citations by year
- 2026: 12 · 2025: 22 · 2024: 23 · 2023: 31 · 2022: 21 · 2021: 15 · 2020: 1
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Diabetes Reports (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R00HL148511, R35HL135818, R01HL128226, K99HL148511, R01HL137234, R56HL106041, R01HL142648, R01HL106041, T32HL007343)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- sleep regularity, circadian rhythm disruption, cardiometabolic risk, metabolic syndrome, type 2 diabetes, adiposity, glycemic dysregulation, social jetlag, rest-activity rhythm, sleep duration variability
- MeSH terms
- Cardiovascular Diseases, Circadian Rhythm, Diabetes Mellitus, Type 2, Humans, Risk Factors, Sleep, Adiposity
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