CoChat
Sign Up
Cited by 120Sleep and related disordersCircadian rhythm and melatoninSleep and Work-Related Fatigue

Association between sleep deficiency and cardiometabolic disease: implications for health disparities

Open access
Rangaraj, Vittobai Rashika, Knutson, Kristen L.·2016·Sleep Medicine
DOI 10.1016/j.sleep.2015.02.535PMC PMC4758899
Open this paper in CoChat — free account

Abstract

Cardiometabolic diseases, which include obesity, diabetes, hypertension and cardiovascular disease, are associated with reduced quality of life and reduced life expectancy. Unfortunately, racial/ethnic and socioeconomic disparities in these diseases exist such that minority populations, such as African Americans and Hispanics, and those of lower socioeconomic status, experience a greater burden. Several reports have indicated that there are differences in sleep duration and quality that mirror the disparities in cardiometabolic disease. The goal of this paper is to review the association between sleep and cardiometabolic disease risk because of the possibility that suboptimal sleep may partially mediate the cardiometabolic disease disparities. We will review both experimental studies that have restricted sleep duration or impaired sleep quality and examined biomarkers of cardiometabolic disease risk, including glucose metabolism and insulin sensitivity, appetite regulation and food intake, and immune function. We will also review observational studies that have examined the association between habitual sleep duration and quality and the prevalence or risk of obesity, diabetes, hypertension and cardiovascular disease. Many experimental and observational studies do support an association between suboptimal sleep and increased cardiometabolic disease risk.

AI snapshot

Written from the paper’s full text.

TL;DR

This review synthesizes experimental and observational evidence that suboptimal sleep is associated with increased cardiometabolic disease risk through impaired glucose metabolism, appetite dysregulation, inflammation, and elevated blood pressure/endothelial dysfunction. Because sleep disparities parallel cardiometabolic disparities, the author proposes that suboptimal sleep may partially mediate racial/ethnic and socioeconomic cardiometabolic health disparities, though this mediation has not been directly tested.

Key findings

  • Experimental sleep restriction impaired glucose metabolism: 4 hours in bed for 6 nights produced a 40% decrease in glucose clearance and a 30% decrease in glucose effectiveness; selective slow-wave sleep suppression decreased insulin sensitivity by 15% (p<0.001).
  • Sleep loss altered appetite and energy balance: 4 hours in bed for 2 days increased hunger/appetite by 23–24% (p<0.01); 4 nights of curtailment increased total energy intake by 20% (p<0.05); 8 days of two-thirds habitual sleep increased caloric intake by 677 kcal/d (p=0.014).
  • Observational meta-analyses found short sleep (<5 h/night) predicted prevalent obesity (pooled OR 1.55, 95% CI 1.43–1.68); prospective diabetes meta-analysis found pooled OR 1.28 (95% CI 1.03–1.6) for short sleep, 1.48 (95% CI 1.13–1.96) for long sleep, 1.57 for difficulty initiating sleep, and 1.84 for difficulty maintaining sleep.
  • Sleep disparities mirror cardiometabolic disparities: a meta-analysis of 14 studies found African Americans slept almost 30 minutes less, took 6 minutes longer to fall asleep, had 5% lower sleep efficiency, and had 8% less slow-wave sleep than non-Hispanic whites.

Methods

  • Design: narrative review; no new primary data were collected. The author reviewed controlled experimental studies of sleep restriction, deprivation, or fragmentation and observational studies of habitual sleep duration/quality.
  • Data/sample: experimental studies examined biomarkers including glucose metabolism and insulin sensitivity, appetite regulation and food intake, immune function, blood pressure, endothelial function, and HPA-axis measures; observational studies included cross-sectional and prospective cohorts and meta-analyses on obesity, diabetes, hypertension, and cardiovascular disease.
  • Main analysis: qualitative synthesis of the literature; no systematic search strategy or formal meta-analysis conducted by the author is reported.

Limitations

  • The paper states that many observational studies relied on subjective sleep duration or quality, which is only moderately associated with objectively estimated sleep; cross-sectional studies cannot infer causal direction, and prospective results are often mixed.
  • The paper states that experimental studies are brief (lasting only a few weeks), whereas chronic cardiometabolic diseases develop over longer periods; obstructive sleep apnea was beyond the scope; and future research must explicitly test whether sleep partially mediates cardiometabolic disease disparities.
  • Evident from the text: as a narrative review, it does not report systematic inclusion criteria, search methods, or formal risk-of-bias assessment; cited findings come from heterogeneous designs and some small samples (e.g., a gene-array analysis limited by n=5).

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.sleep.2015.02.535

Cites

217 of 217 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 236 cited sources checked · 0 supported · 0 flagged

  • Interpretationnone given

    Many experimental and observational studies support an association between suboptimal sleep and increased cardiometabolic disease risk.

    “Many experimental and observational studies do support an association between suboptimal sleep and increased cardiometabolic disease risk.”
    Quote in the paperSubstantial claim
  • Premisecitation

    Two nights of sleep curtailment to 4 hours in bed per night in healthy men decreased insulin sensitivity compared to 2 nights of unrestricted sleep.

    “2 nights of sleep curtailment to 4 hours in bed per night in healthy men reported a significant decrease in insulin sensitivity compared to 2 nights of unrestricted sleep [23]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] Schmid SM Hallschmid M Jauch-Chara K Wilms B Lehnert H Born J Schultes B Disturbed glucoregulatory response to food intake after moderate sleep restriction Sleep 2011 34 371 21358855 PMC3041714 source

      Not checked in the free run.

  • Premisecitation

    Studies using polysomnography consistently observed lower amounts of slow wave sleep and reduced sleep efficiency among African Americans compared to non-Hispanic whites.

    “several studies that used polysomnography (PSG) consistently observed lower amounts of slow wave sleep and reduced sleep efficiency among African Americans compared to non-Hispanic whites [13–16]”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [13] Profant J Ancoli-Israel S Dimsdale JE Are there ethnic differences in sleep architecture? Amer J Hum Biol 2002 14 321 6 12001088 source

      Not checked in the free run.

    • cites [14] Redline S Kirchner HL Quan SF Gottlieb DJ Kapur V Newman A The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture Arch Intern Med 2004 164 406 18 14980992 source

      Not checked in the free run.

    • cites [15] Mezick EJ Matthews KA Hall M Strollo PJ Jr Buysse DJ Kamarck TW Owens JF Reis SE Influence of race and socioeconomic status on sleep: Pittsburgh SleepSCORE project Psychosom Med 2008 70 410 6 18480189 PMC2887747 source

      Not checked in the free run.

    • cites [16] Hall MH Matthews KA Kravitz HM Gold EB Buysse DJ Bromberger JT Owens JF Sowers M Race and financial strain are independent correlates of sleep in midlife women: the SWAN sleep study Sleep 2009 32 73 82 19189781 PMC2625326

      Not checked in the free run.

  • Premisecitation

    Spiegel et al. demonstrated a direct effect of sleep restriction on glucose metabolism.

    “Spiegel et al demonstrated a direct effect of sleep restriction on glucose metabolism [21].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Spiegel K Leproult R Van Cauter E Impact of sleep debt on metabolic and endocrine function Lancet 1999 354 1435 9 10543671 source

      Not checked in the free run.

  • Premisecitation

    Persons with lower socioeconomic status are at increased risk of cardiometabolic disease.

    “Persons with lower socioeconomic status are also at an increased risk of cardiometabolic disease [5, 6]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [5] Everson SA Maty SC Lynch JW Kaplan GA Epidemiologic evidence for the relation between socioeconomic status and depression, obesity, and diabetes J Psychosom Res 2002 53 891 5 12377299 source

      Not checked in the free run.

    • cites [6] Elovainio M Ferrie JE Singh-Manoux A Shipley M Batty GD Head J Hamer M Jokela M Virtanen M Brunner E Marmot MG Kivimaki M Socioeconomic differences in cardiometabolic factors: social causation or health-related selection? Evidence from the Whitehall II Cohort Study, 1991–2004 Am J Epidemiol 2011 174 779 89 21813793 PMC3176829 source

      Not checked in the free run.

  • May combine two claims. 72
  • Classified as probably not a substantial claim. 6

  • May combine two claims.

    Premisecitation

    A meta-analysis of 14 studies of people without suspected sleep disorders using actigraphy or PSG found that African Americans sleep almost 30 minutes less, take 6 minutes longer to fall asleep, have 5% lower sleep efficiency and have 8% less slow wave sleep than non-Hispanic whites.

    “A recent meta-analysis of data from 14 studies that enrolled people without suspected sleep disorders and used either actigraphy or PSG demonstrated that on average African Americans sleep almost 30 minutes less, take 6 minutes longer to fall sleep, have 5% lower sleep efficiency and have 8% less SWS than non-Hispanic whites [17]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [17] Ruiter ME Decoster J Jacobs L Lichstein KL Normal sleep in African-Americans and Caucasian-Americans: A meta-analysis Sleep Med 2011 12 209 14 21317037 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Sleep disorders such as obstructive sleep apnea may be more common, go undiagnosed more frequently and may be treated less efficaciously in African American patients.

    “sleep disorders such as obstructive sleep apnea (OSA) may be more common, go undiagnosed more frequently and may be treated less efficaciously in African American patients [18, 19]”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [18] Ruiter ME DeCoster J Jacobs L Lichstein KL Sleep disorders in African Americans and Caucasian Americans: a meta-analysis Behav Sleep Med 2010 8 246 59 20924837 source

      Not checked in the free run.

    • cites [19] Jean-Louis G von Gizycki H Zizi F Dharawat A Lazar JM Brown CD Evaluation of sleep apnea in a sample of black patients J Clin Sleep Med 2008 4 421 5 18853698 PMC2576327 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Racial/ethnic and socioeconomic disparities exist in cardiometabolic diseases, with minority populations such as African Americans and Hispanics and those of lower socioeconomic status experiencing a greater burden.

    “Unfortunately, racial/ethnic and socioeconomic disparities in these diseases exist such that minority populations, such as African Americans and Hispanics, and those of lower socioeconomic status, experience a greater burden.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [2] Ogden CL Carroll MD Curtin LR McDowell MA Tabak CJ Flegal KM Prevalence of overweight and obesity in the United States, 1999–2004 JAMA 2006 295 1549 55 16595758 source

      Not checked in the free run.

    • cites [3] Ong KL Cheung BM Wong LY Wat NM Tan KC Lam KS Prevalence, Treatment, and Control of Diagnosed Diabetes in the U.S. National Health and Nutrition Examination Survey 1999–2004 Ann Epidemiol 2008 18 222 9 18201902 source

      Not checked in the free run.

    • cites [4] Lloyd-Jones D Adams RJ Brown TM Carnethon M Dai S De Simone G Ferguson TB Ford E Furie K Gillespie C Go A Greenlund K Haase N Hailpern S Ho PM Howard V Kissela B Kittner S Lackland D Lisabeth L Marelli A McDermott MM Meigs J Mozaffarian D Mussolino M Nichol G Roger V Rosamond W Sacco R Sorlie P Stafford R Thom T Wasserthiel-Smoller S Wong ND Wylie-Rosett J Heart Disease and Stroke Statistics--2010 Update. A Report From the American Heart Association Circulation 2009 121 e46 e215 20019324

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Minority groups, particularly African Americans, have shorter habitual sleep duration and poorer habitual sleep quality based on objectively-measured wrist actigraphy compared to non-Hispanic whites.

    “Minority groups, particularly African Americans, have shorter habitual sleep duration and poorer habitual sleep quality based on objectively-measured wrist actigraphy compared to non-Hispanic whites [11, 12]”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [11] Lauderdale DS Knutson KL Yan LL Rathouz PJ Hulley SB Sidney S Liu K Objectively measured sleep characteristics among early-middle-aged adults: the CARDIA study Am J Epidemiol 2006 164 5 16 16740591 source

      Not checked in the free run.

    • cites [12] Jean-Louis G Kripke DF Ancoli-Israel S Klauber MR Sepulveda RS Sleep duration, illumination, and activity patterns in a population sample: effects of gender and ethnicity Biol Psychiatry 2000 47 921 7 10807965 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Obesity rates are higher in African Americans (45%) and Mexican-Americans (36.8%) compared to whites (30%).

    “Obesity rates are higher in African Americans (45%) and Mexican-Americans (36.8%) compared to whites (30%) [2]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Ogden CL Carroll MD Curtin LR McDowell MA Tabak CJ Flegal KM Prevalence of overweight and obesity in the United States, 1999–2004 JAMA 2006 295 1549 55 16595758 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Acute partial sleep restriction of 4 hours in bed for one night compared with unrestricted sleep increased endogenous glucose production (p=0.017) and decreased glucose disposal rate (p=0.009) from a hyperinsulinemic clamp, indicating decreased hepatic and peripheral insulin sensitivities.

    “Acute partial sleep restriction of 4 hours in bed for one night when compared with a night of unrestricted sleep showed an increase in endogenous glucose production (p=0.017) and a decrease in glucose disposal rate (p=0.009) from a hyperinsulinemic clamp assessment indicating a decrease in hepatic and peripheral insulin sensitivities [22].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [22] Donga E van Dijk M van Dijk JG Biermasz NR Lammers GJ van Kralingen KW Corssmit EP Romijn JA A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects J Clin Endocrinol Metab 2010 95 2963 8 20371664 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The prevalence of hypertension is higher among African-American adults compared to non-Hispanic whites.

    “The prevalence of hypertension is also higher among African-American adults compared to non-Hispanic whites [4]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Lloyd-Jones D Adams RJ Brown TM Carnethon M Dai S De Simone G Ferguson TB Ford E Furie K Gillespie C Go A Greenlund K Haase N Hailpern S Ho PM Howard V Kissela B Kittner S Lackland D Lisabeth L Marelli A McDermott MM Meigs J Mozaffarian D Mussolino M Nichol G Roger V Rosamond W Sacco R Sorlie P Stafford R Thom T Wasserthiel-Smoller S Wong ND Wylie-Rosett J Heart Disease and Stroke Statistics--2010 Update. A Report From the American Heart Association Circulation 2009 121 e46 e215 20019324

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    More REM and more SWS were associated with less fat and carbohydrate intake.

    “Thus, more REM and more SWS were associated with less fat and carbohydrate intake.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Sleep durations of 6 hours or less across multiple consecutive nights and poor sleep quality have profound effects on glucose metabolism and homeostasis.

    “These studies collectively suggest that sleep durations of 6 hours or less across multiple consecutive nights and poor sleep quality has profound effects on glucose metabolism and homeostasis.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    These studies bolster the notion that sleep loss could lead to increased appetite, particularly for unhealthy foods, and could promote weight gain.

    “These studies bolster the notion that sleep loss could lead to increased appetite, particularly for unhealthy foods, could promote weight gain.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Fifteen men and 15 women restricted to 4 hours in bed per night for 5 days after 9 hours in bed per night for 5 days consumed more energy on day 5 after short sleep (2813.6 ± 593.0 kcal) than after 9 hours in bed (2517.7 ± 593.0 kcal; p=0.023), mostly due to increased consumption of fat (p=0.01), notably saturated fat (p=0.038).

    “In another study, 15 men and 15 women were restricted to 4 hours in bed per night for 5 days after 9 hours in bed per night for 5 days [56]. The diet on the first 4 days was controlled, while ad libitum food intake was allowed on the last day. Participants consumed more energy on day 5 after short sleep (2813.6 ± 593.0 kcal) than after 9 hours in bed (2517.7 ± 593.0 kcal; p = 0.023). This effect”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [56] St-Onge MP Roberts AL Chen J Kelleman M O’Keeffe M Roychoudhury A Jones PJ Short sleep duration increases energy intakes but does not change energy expenditure in normal-weight individuals Am J Clin Nutr 2011 94 410 6 21715510 PMC3142720 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Partial sleep restriction of 4 hours in bed per night for 2 consecutive days induced an increase in hunger and appetite (+23-24%, p<0.01), especially for foods with high carbohydrate content such as sweets and salty snacks (p<0.02).

    “Partial sleep restriction of 4 hours in bed per night for 2 consecutive days induced an increase in hunger and appetite (+23–24%, p<0.01) especially for foods with high carbohydrate content such as sweets and salty snacks (p<0.02) [40].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Spiegel K Tasali E Penev P Van Cauter E Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite Ann Intern Med 2004 141 846 50 15583226 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A single night of slow wave sleep or REM suppression compared to a night of uninterrupted sleep in 16 healthy men decreased insulin sensitivity after SWS suppression (−15%, p<0.001) but not after REM suppression.

    “A single night of SWS or REM suppression was compared to a night of uninterrupted sleep in 16 healthy men and insulin sensitivity was decreased after SWS-suppression (−15%, p<0.001) but not REM suppression [29].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Herzog N Jauch-Chara K Hyzy F Richter A Friedrich A Benedict C Oltmanns KM Selective slow wave sleep but not rapid eye movement sleep suppression impairs morning glucose tolerance in healthy men Psychoneuroendocrinology 2013 38 2075 82 23602132 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Inverse associations between REM sleep duration and hunger (p<0.031) and between stage 2 sleep and appetite for sweet (p<0.015) and salty (p<0.046) foods were detected.

    “Specifically, inverse associations between REM sleep duration and hunger (p<0.031) and between stage 2 sleep and appetite for sweet (p<0.015) and salty (p<0.046) foods were detected in one study [57].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57] Shechter A O’Keeffe M Roberts AL Zammit GK RoyChoudhury A St-Onge M-P Alterations in sleep architecture in response to experimental sleep curtailment are associated with signs of positive energy balance American Journal of Physiology - Regulatory, Integrative and Comparative Physiology 2012 303 R883 R9 PMC3517705 22972835 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A night of fragmented sleep in male subjects resulted in a decrease in REM (p<0.05) and an increase in post-dinner desire-to-eat ratings (p<0.05) the following day.

    “In another study that used PSG, a night of fragmented sleep in male subjects resulted in a decrease in REM (p<0.05) and an increase in the post-dinner desire-to-eat ratings (p<0.05) the following day [46].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [46] Gonnissen HKJ Hursel R Rutters F Martens EAP Westerterp-Plantenga MS Effects of sleep fragmentation on appetite and related hormone concentrations over 24 h in healthy men The British Journal of Nutrition 2013 109 748 56 22682471 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Three days of 4 hours in bed per night compared to 9 hours in bed per night for 3 days in adolescent boys resulted in an increase in fasting insulin (+59%, p=0.001), fasting C-peptide (+24%, p<0.001), post-prandial C-peptide (+11%, p=0.018), and a 24% decrease in 24-hour epinephrine levels (p=0.013).

    “Three days of 4 hours in bed per night compared to 9 hours in bed per night for 3 days in adolescent boys resulted in an increase in fasting insulin (+59%, p=0.001), fasting C-peptide (+24%, p<0.001) and post-prandial C-peptide (+11%, p=0.018), in addition to a 24% decrease in 24-hour epinephrine levels (p=0.013) [34].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [34] Klingenberg L Chaput J-P Holmback U Visby T Jennum P Nikolic M Astrup A Sjodin A Acute Sleep Restriction Reduces Insulin Sensitivity in Adolescent Boys Sleep 2013 36 1085 90 23814346 PMC3669075 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationnone given

    Experimental studies of sleep restriction have demonstrated an effect of short sleep on markers of positive energy balance such as decreased energy expenditure, increased feelings of hunger and appetite, increased food intake and changes in appetite regulating hormones.

    “Experimental studies of sleep restriction have demonstrated an effect of short sleep on markers of positive energy balance such as decreased energy expenditure (EE), increased feelings of hunger and appetite, increased food intake and changes in appetite regulating hormones.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Fragmented sleep across the night and suppression of Stage N3 decreased glucose tolerance and insulin sensitivity.

    “Quality of sleep also affects insulin sensitivity as demonstrated by a study that fragmented sleep across the night [27], and another that suppressed Stage N3 (deep non-REM sleep or slow wave sleep [SWS]) [28]. In both of these studies decreased glucose tolerance and insulin sensitivity were observed.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [27] Stamatakis KA Effects of Sleep Fragmentation on Glucose Metabolism in Normal Subjects CHEST Journal 2010 137 95 PMC2803120 19542260 source

      Not checked in the free run.

    • cites [28] Tasali E Leproult R Ehrmann DA Van Cauter E Slow-wave sleep and the risk of type 2 diabetes in humans Proc Natl Acad Sci U S A 2008 105 1044 9 18172212 PMC2242689 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Limiting time in bed to 5.5 hours per night for 2 weeks with ad libitum access to food and snacks did not observe changes in caloric intake during meals or energy expenditure, but calories from snacks increased (p<0.04).

    “In a study that limited time in bed to 5.5 hours in bed per night for 2 weeks with ad libitum access to food and snacks did not observe changes in caloric intake during meals or energy expenditure, but calories from snacks increased (p <0.04) [26].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Nedeltcheva AV Kessler L Imperial J Penev PD Exposure to recurrent sleep restriction in the setting of high caloric intake and physical inactivity results in increased insulin resistance and reduced glucose tolerance J Clin Endocrinol Metab 2009 94 3242 50 19567526 PMC2819825 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Interpreting discrepant results regarding sleep restriction and leptin levels is complicated by the dynamic relationship between leptin, food intake and body fat changes, and these three components are not always measured and/or controlled.

    “Interpreting the discrepant results regarding sleep restriction and leptin levels is further complicated by the dynamic relationship between leptin, food intake and body fat changes, and these three components are not always measured and/or controlled.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In that study, a parallel increase in food intake (+6%, p<0.05) was observed, and post-dinner snacking increased with a greater preference for carbohydrates.

    “A parallel increase in food intake (+6%, p<0.05) was observed. Post-dinner snacking increased with a greater preference for carbohydrates.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] Markwald RR Melanson EL Smith MR Higgins J Perreault L Eckel RH Wright KP Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain Proc Natl Acad Sci U S A 2013 110 5695 700 23479616 PMC3619301 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Partial sleep deprivation of 5 hours in bed for one week in men and 4 days of decreasing sleep curtailment in women also observed decreased insulin sensitivity and glucose tolerance.

    “In other studies that enforced partial sleep deprivation (5 hours in bed) for one week in men [24] and 4 days of decreasing sleep curtailment (7 hours, 6 hours, 4 hours, 4 hours on consecutive nights) in women [25] also observed decreased insulin sensitivity and glucose tolerance.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [24] Buxton OM Pavlova M Reid EW Wang W Simonson DC Adler GK Sleep restriction for 1 week reduces insulin sensitivity in healthy men Diabetes 2010 59 2126 33 20585000 PMC2927933 source

      Not checked in the free run.

    • cites [25] Bosy-Westphal A Hinrichs S Jauch-Chara K Hitze B Later W Wilms B Settler U Peters A Kiosz D Muller MJ Influence of partial sleep deprivation on energy balance and insulin sensitivity in healthy women Obes Facts 2008 1 266 73 20054188 PMC6515888 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Different effects on food intake across studies could be attributed to differences in study design such as availability of types of food, snacks, and participant characteristics such as age, gender and BMI.

    “When comparing these studies, the different effects on food intake could be attributed to differences in study design such as availability of types of food, snacks, and participant characteristics such as age, gender and BMI.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Two crossover studies of a single night of total sleep deprivation or partial sleep deprivation showed decreased basal glucagon levels, while catecholamine levels remained unchanged.

    “Two crossover studies of a single night of total sleep [32] or partial sleep [30] deprivation showed decreased basal glucagon levels, however catecholamines levels remained unchanged.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [32] Schmid SM Hallschmid M Jauch-Chara K Bandorf N Born J Schultes B Sleep Loss Alters Basal Metabolic Hormone Secretion and Modulates the Dynamic Counterregulatory Response to Hypoglycemia The Journal of Clinical Endocrinology & Metabolism 2007 92 3044 51 17519315 source

      Not checked in the free run.

    • cites [30] Schmid SM Jauch-Chara K Hallschmid M Schultes B Mild Sleep Restriction Acutely Reduces Plasma Glucagon Levels in Healthy Men The Journal of Clinical Endocrinology & Metabolism 2009 94 5169 73 19837925 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    After 36 hours of continuous sleep deprivation, sympathetic modulation of BP variability significantly increased and parasympathetic modulation of heart rate variability significantly decreased.

    “This study also observed a significant increase in sympathetic modulation of BP variability and reduction in parasympathetic modulation of heart rate variability, which suggests increased sympathetic nervous activity.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [69] Zhong X Hilton HJ Gates GJ Jelic S Stern Y Bartels MN DeMeersman RE Basner RC Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation J Appl Physiol 2005 98 2024 32 15718408 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A single night of sleep restricted to 4 hours in bed per night resulted in a 22% increase in caloric intake (p<0.01) with a significant increase in physical activity recorded by an actimeter despite an increase in sleepiness.

    “Another study of a single night of sleep restricted to 4 hours in bed per night resulted in a 22% increase in caloric intake (p<0.01) with a significant increase in physical activity recorded by an actimeter despite an increase in sleepiness [54].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] Brondel L Romer MA Nougues PM Touyarou P Davenne D Acute partial sleep deprivation increases food intake in healthy men Am J Clin Nutr 2010 91 1550 9 20357041 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    After a night of total sleep deprivation in 8 healthy men and women, systolic blood pressure (p=0.002) and diastolic blood pressure (p=0.05) were significantly higher than after a night of regular sleep; morning plasma catecholamines and heart rate remained unchanged.

    “After a night of total sleep deprivation in 8 healthy men and women, the systolic BP (SBP) (p=0.002) and diastolic BP (DBP) (p=0.05) were significantly higher than after a night of regular sleep. However, the morning plasma catecholamines and heart rate remain unchanged [65].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [65] Kato M Phillips BG Sigurdsson G Narkiewicz K Pesek CA Somers VK Effects of sleep deprivation on neural circulatory control Hypertension 2000 35 1173 5 10818083 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Acute sleep loss affects HRV, BP and arterial baroreflex sensitivity, and a prolonged effect of sleep loss on these cardiac measures could increase the risk for heart diseases.

    “In summary, the above studies demonstrate the effects of acute sleep loss on HRV, BP and arterial baroreflex sensitivity and a prolonged effect of sleep loss on these cardiac measures could increase the risk for heart diseases.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    After one night of total sleep deprivation, 16 healthy normal-weight men chose larger food portions (+14%, p=0.02) in correspondence with increased hunger status; portions of snacks consumed after breakfast also increased (+16%, p=0.02).

    “After one night of TSD, 16 healthy normal-weight men choose larger food portions (+14%, p=0.02) in correspondence with increased hunger status [59]. The portions of snacks consumed after breakfast also increased (+16%, p=0.02).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] Hogenkamp PS Nilsson E Nilsson VC Chapman CD Vogel H Lundberg LS Zarei S Cedernaes J Rångtell FH Broman J-E Dickson SL Brunstrom JM Benedict C Schiöth HB Acute sleep deprivation increases portion size and affects food choice in young men Psychoneuroendocrinology 2013 38 1668 74 23428257 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The association between ghrelin and sleep loss is not consistent, which may be due to duration and severity of sleep restriction as well as to the complex association between food intake and regulation of this hormone.

    “Thus, the association between ghrelin and sleep loss is not consistent, which may be due to duration and severity of sleep restriction as well as to the complex association between food intake and regulation of this hormone.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    These two studies attribute the effects of sleep deprivation on baroreflex to changes in peripheral and central mechanisms but did not observe an increase in their measures of sympathetic nervous activity.

    “These two studies attribute the effects of sleep deprivation on baroreflex to changes in peripheral and central mechanisms but did not observe an increase in their measures of sympathetic nervous activity.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [65] Kato M Phillips BG Sigurdsson G Narkiewicz K Pesek CA Somers VK Effects of sleep deprivation on neural circulatory control Hypertension 2000 35 1173 5 10818083 source

      Not checked in the free run.

    • cites [66] Ogawa Y Kanbayashi T Saito Y Takahashi Y Kitajima T Takahashi K Hishikawa Y Shimizu T Total sleep deprivation elevates blood pressure through arterial baroreflex resetting: a study with microneurographic technique [see comment] Sleep 2003 26 986 9 14746379 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    While ghrelin and leptin levels remain unchanged in some studies, a few others have shown significant changes after sleep deprivation.

    “While ghrelin and leptin levels remain unchanged in some studies [46, 47, 49, 50], a few others have shown significant changes after sleep deprivation.”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [46] Gonnissen HKJ Hursel R Rutters F Martens EAP Westerterp-Plantenga MS Effects of sleep fragmentation on appetite and related hormone concentrations over 24 h in healthy men The British Journal of Nutrition 2013 109 748 56 22682471 source

      Not checked in the free run.

    • cites [47] Calvin AD Carter RE Adachi T Macedo P Albuquerque FN van der Walt C Bukartyk J Davison DE Levine JA Somers VK Effects of Experimental Sleep Restriction on Caloric Intake and Activity Energy Expenditure Chest 2013 PMC3707179 23392199 source

      Not checked in the free run.

    • cites [49] Schmid SM Hallschmid M Jauch-Chara K Wilms B Benedict C Lehnert H Born J Schultes B Short-term sleep loss decreases physical activity under free-living conditions but does not increase food intake under time-deprived laboratory conditions in healthy men Am J Clin Nutr 2009 90 1476 82 19846546 source

      Not checked in the free run.

    • cites [50] Nedeltcheva AV Kilkus JM Imperial J Kasza K Schoeller DA Penev PD Sleep curtailment is accompanied by increased intake of calories from snacks Am J Clin Nutr 2009 89 126 33 19056602 PMC2615460 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Although changes in hormone levels promoted satiety and reduced hunger, there was a significant increase in overall food intake promoting overeating in that study.

    “Although the changes in hormone levels promoted satiety and reduced hunger, there was a significant increase in overall food intake promoting overeating in this study.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] Markwald RR Melanson EL Smith MR Higgins J Perreault L Eckel RH Wright KP Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain Proc Natl Acad Sci U S A 2013 110 5695 700 23479616 PMC3619301 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Increased food intake during insufficient sleep is a physiological adaptation to provide energy needed to sustain additional wakefulness; yet when food is easily accessible, intake surpasses need.

    “The data summarized above suggests that increased food intake during insufficient sleep is a physiological adaptation to provide energy needed to sustain additional wakefulness; yet when food is easily accessible, intake surpasses need.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In 6 healthy men, total sleep deprivation increased diastolic blood pressure (p=0.02) and increased arterial baroreflex set-point by 12 mm Hg (p<0.05); no changes in morning plasma catecholamines, including epinephrine and norepinephrine, dopamine, or cortisol were recorded.

    “In another study of 6 healthy men, TSD increased diastolic BP (p=0.02) and increased arterial baroreflex set-point by 12 mm Hg (p<0.05) [66]. No changes in morning plasma catecholamines, including epinephrine and norepinephrine, dopamine, or cortisol were recorded.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66] Ogawa Y Kanbayashi T Saito Y Takahashi Y Kitajima T Takahashi K Hishikawa Y Shimizu T Total sleep deprivation elevates blood pressure through arterial baroreflex resetting: a study with microneurographic technique [see comment] Sleep 2003 26 986 9 14746379 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In 9 healthy normal-weight men, plasma ghrelin levels were 22% higher after total sleep deprivation than after 7 hours of sleep (p<0.05); feelings of hunger were elevated, whereas morning leptin concentrations remained unaffected.

    “In yet another study with 9 healthy normal-weight men plasma ghrelin levels were 22% higher after total SD than after 7 hours of sleep (p <0.05) [51]. Feelings of hunger were elevated, whereas morning leptin concentrations remained unaffected.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] Schmid SM Hallschmid M Jauch-Chara K Born J Schultes B A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men J Sleep Res 2008 17 331 4 18564298 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Sleep loss decreases activity in the appetite evaluation regions within human frontal cortex and insula cortex during food desirability choices combined with an increase or amplification of activity within the amygdala promoting a desire for high-calorie foods.

    “Another study showed sleep loss decreases activity in the appetite evaluation regions within human frontal cortex and insula cortex during food desirability choices combined with an increase or amplification of activity within the amygdala promoting a desire for high-calorie foods [62].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62] Greer SM Goldstein AN Walker MP The impact of sleep deprivation on food desire in the human brain Nature communications 2013 4 2259 PMC3763921 23922121 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In 16 healthy normal-weight adults (8 men and 8 women), 24-h ghrelin levels decreased after a night of partial sleep deprivation (5 hours in bed) compared to baseline (−30%, p<0.001), while 24-h leptin levels increased (+22%, p<0.05) under the same conditions.

    “On the contrary, in a study of 16 healthy normal-weight adults (8 men and 8 women), 24-h ghrelin levels decreased after a night of PSD (5 hours in bed) in comparison to baseline (−30%, p<0.001), while the 24-h leptin levels increased (+22%, p<0.05) under the same conditions [41].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] Markwald RR Melanson EL Smith MR Higgins J Perreault L Eckel RH Wright KP Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain Proc Natl Acad Sci U S A 2013 110 5695 700 23479616 PMC3619301 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In 15 healthy men, sleep deprivation after 2 nights of restricted bedtime (4.5 hours in bed per night) significantly decreased physical activity (p=0.008) and shifted physical activity towards lower intensity activity (p<0.05) without any changes in energy intake.

    “In 15 healthy men spontaneous physical activity was recorded by accelerometer during a 15-h daytime period after 2 nights of restricted bedtime (4.5 hours in bed per night) [49]. Sleep deprivation significantly decreased physical activity (p=0.008) and also shifted the physical activity towards lower intensity activity (p<0.05) without any changes in energy intake.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [49] Schmid SM Hallschmid M Jauch-Chara K Wilms B Benedict C Lehnert H Born J Schultes B Short-term sleep loss decreases physical activity under free-living conditions but does not increase food intake under time-deprived laboratory conditions in healthy men Am J Clin Nutr 2009 90 1476 82 19846546 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Participants had an overall positive energy balance with an average yet statistically insignificant increase in weight gain in the 5-h per night sleep condition.

    “The study participants had an overall positive energy balance with an average yet statistically insignificant increase in weight gain in the 5-h per night sleep condition.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] Markwald RR Melanson EL Smith MR Higgins J Perreault L Eckel RH Wright KP Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain Proc Natl Acad Sci U S A 2013 110 5695 700 23479616 PMC3619301 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a randomized crossover study of 12 healthy normal-weight men, 2 consecutive nights of partial sleep deprivation (4 hours in bed) compared with 2 consecutive nights of 10 hours in bed elevated ghrelin levels (+28%, p<0.04), along with an increase in subjective hunger and appetite (p<0.01).

    “In a randomized crossover study of 12 healthy normal-weight men, 2 consecutive nights of PSD (4 hours in bed) was compared with 2 consecutive nights of 10 hours in bed [40]. Ghrelin levels were elevated (+28%, p <0.04), along with an increase in subjective hunger and appetite (p<0.01).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Spiegel K Tasali E Penev P Van Cauter E Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite Ann Intern Med 2004 141 846 50 15583226 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Non-dipping in blood pressure is associated with cardiovascular disease risk and has been associated with poor sleep.

    “Non-dipping in BP is associated with CVD risk [63] and has been associated with poor sleep [64].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [63] Hermida RC Ayala DE Mojon A Fernandez JR Blunted sleep-time relative blood pressure decline increases cardiovascular risk independent of blood pressure level--the “normotensive non-dipper” paradox Chronobiol Int 2013 30 87 98 23039824 source

      Not checked in the free run.

    • cites [64] Ulu SM Ulu S Ulasli SS Yaman G Ahsen A Ozkececi G Yuksel S Is impaired sleep quality responsible for a nondipping pattern even in normotensive individuals? Blood Press Monit 2013 18 183 7 23695348 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    If sleep loss increases appetite and subsequently food intake without a compensatory and equivalent increase in energy expenditure, then sleep loss could increase risk of weight gain and obesity.

    “If sleep loss increases appetite and subsequently food intake without a compensatory and equivalent increase in energy expenditure, then sleep loss could increase risk of weight gain and obesity.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Total sleep deprivation and partial sleep deprivation lead to greater stimulation of brain regions in response to hedonic food stimuli.

    “TSD [60] and PSD [61] lead to greater stimulation of brain regions in response to hedonic food stimuli.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [60] Benedict C Brooks SJ O’Daly OG Almen MS Morell A Aberg K Gingnell M Schultes B Hallschmid M Broman JE Larsson EM Schioth HB Acute sleep deprivation enhances the brain’s response to hedonic food stimuli: an fMRI study J Clin Endocrinol Metab 2012 97 E443 7 22259064 source

      Not checked in the free run.

    • cites [61] St-Onge MP McReynolds A Trivedi ZB Roberts AL Sy M Hirsch J Sleep restriction leads to increased activation of brain regions sensitive to food stimuli Am J Clin Nutr 2012 95 818 24 22357722 PMC3302360 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In 14 normal-weight men after 24-h of continuous wakefulness, resting (−5%, p<0.05) and postprandial (−20%, p<0.001) energy expenditure were significantly reduced after one night of total sleep deprivation with a significant increase in hunger ratings while no changes in ad libitum food intake in the afternoon were observed.

    “In 14 normal-weight men in the morning after 24-h of continuous wakefulness both resting and postprandial EE were assessed along with hunger ratings before the standardized breakfast. The resting (−5%, p<0.05) and postprandial (−20%, p<0.001) EE were significantly reduced after one night of total sleep deprivation with a significant increase in hunger ratings while no changes in ad libitum food”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Benedict C Hallschmid M Lassen A Mahnke C Schultes B Schiöth HB Born J Lange T Acute sleep deprivation reduces energy expenditure in healthy men The American Journal of Clinical Nutrition 2011 93 1229 36 21471283 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Impairment of endothelial function is a mechanism in the development of CVD and an independent predictor of CVD risk.

    “Impairment of endothelial function is a mechanism in the development of CVD [73] and also an independent predictor of CVD risk [74].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [73] Landmesser U Drexler H The clinical significance of endothelial dysfunction Curr Opin Cardiol 2005 20 547 51 16234629 source

      Not checked in the free run.

    • cites [74] Hadi HA Carr CS Al Suwaidi J Endothelial dysfunction: cardiovascular risk factors, therapy, and outcome Vasc Health Risk Manag 2005 1 183 98 17319104 PMC1993955

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    One night of total sleep deprivation in 7 healthy participants increased energy expenditure by 32% during the night of TSD and then decreased by 4% during the recovery night when compared to baseline.

    “One night of TSD in 7 healthy participants increased EE by 32% during the night of TSD and then decreased by 4% during the recovery night when compared to baseline [58].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] Jung CM Melanson EL Frydendall EJ Perreault L Eckel RH Wright KP Energy expenditure during sleep, sleep deprivation and sleep following sleep deprivation in adult humans The Journal of Physiology 2011 589 235 44 21059762 PMC3039272 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Numerous studies have observed consistent associations using subjective sleep assessments that support the findings of the laboratory studies; sleep deficiency appears to be associated with cardiometabolic disease.

    “Nonetheless, numerous studies have observed consistent associations using subjective sleep assessments that support the findings of the laboratory studies; sleep deficiency appears to be associated with cardiometabolic disease.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported sleep duration is sufficiently valid to support associations between sleep deficiency and cardiometabolic disease despite being only moderately associated with objectively-estimated sleep duration.

  • May combine two claims.

    Premisecitation

    Acute sleep restriction (3 hours in bed for one night) and prolonged sleep restriction (4 hours in bed per night for 5 days) resulted in elevated evening cortisol levels.

    “This was shown in the study of acute sleep restriction (3 hours in bed for one night) [45] and prolonged sleep restriction (4 hours in bed per night for 5 days) [23, 42].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [45] Omisade A Buxton OM Rusak B Impact of acute sleep restriction on cortisol and leptin levels in young women Physiol Behav 2010 99 651 6 20138072 source

      Not checked in the free run.

    • cites [23] Schmid SM Hallschmid M Jauch-Chara K Wilms B Lehnert H Born J Schultes B Disturbed glucoregulatory response to food intake after moderate sleep restriction Sleep 2011 34 371 21358855 PMC3041714 source

      Not checked in the free run.

    • cites [42] Reynolds AC Dorrian J Liu PY Van Dongen HPA Wittert GA Harmer LJ Banks S Impact of Five Nights of Sleep Restriction on Glucose Metabolism, Leptin and Testosterone in Young Adult Men PLoS ONE 2012 7 PMC3402517 22844441 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationnone given

    Some but not all prospective studies found longitudinal associations between short sleep duration and increases in body weight, and some found long sleep associated with greater weight gain or less weight loss.

    “Some, but not all, prospective studies found longitudinal associations between short sleep duration and increases in body weight and some found long sleep associated with greater weight gain or less weight loss.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Sleep loss alters immune homeostasis and tilts the scales towards proinflammation.

    “In conclusion, sleep loss alters the immune homeostasis and tilts the scales towards proinflammation.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The Wisconsin Sleep Cohort Study found that total sleep time from one night of polysomnography was inversely associated with ghrelin levels (beta = −0.69, p=0.008) but was not associated with leptin levels.

    “The Wisconsin Sleep Cohort Study found that total sleep time from one night of polysomnography was inversely associated with ghrelin levels (beta = −0.69, p=0.008) but was not associated with leptin levels [149].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [149] Taheri S Lin L Austin D Young T Mignot E Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index PLoS Med 2004 1 e62 15602591 PMC535701 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    After a night of total sleep deprivation, mean daytime IL-6 values were significantly higher (p<0.05) than baseline and a nighttime undersecretion (p<0.05) was reported.

    “After a night of TSD, mean daytime IL-6 values were significantly higher (p<0.05) than baseline and a nighttime undersecretion (p<0.05) was reported [106].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [106] Vgontzas AN Circadian Interleukin-6 Secretion and Quantity and Depth of Sleep The Journal of Clinical Endocrinology & Metabolism 1999 84 2603 7 10443646 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    REM sleep is positively correlated with morning cortisol levels and inversely associated with afternoon cortisol levels.

    “REM sleep has been shown to be positively correlated with morning cortisol levels [86] but inversely associated with afternoon cortisol levels [87] and could partly explain decreased morning cortisol levels after sleep restriction.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [86] Rutters F Gonnissen HK Hursel R Lemmens SG Martens EA Westerterp-Plantenga MS Distinct associations between energy balance and the sleep characteristics slow wave sleep and rapid eye movement sleep Int J Obes (Lond) 2012 36 1346 52 22234280 source

      Not checked in the free run.

    • cites [87] Gonnissen HKJ Mazuy C Rutters F Martens EAP Adam TC Westerterp-Plantenga MS Sleep Architecture When Sleeping at an Unusual Circadian Time and Associations with Insulin Sensitivity PLoS ONE 2013 8 PMC3738551 23951335 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Even if recovery sleep restores the immune balance, chronic sleep deprivation for weeks, months and even years could potentially activate a state of chronic low-grade inflammation that could cause metabolic distress.

    “Even if recovery sleep has been shown to restore the immune balance, chronic sleep deprivation for weeks, months and even years, could potentially activate a state of chronic low-grade inflammation that could cause metabolic distress.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    An increase in WBC count (p=0.03) and neutrophils (p=0.01) was observed the morning after 3 nights of partial sleep deprivation to 4 hours in bed per night, with no changes in monocytes, lymphocytes and CRP.

    “An increase in WBC count (p=0.03) and neutrophils (p=0.01) was observed the morning after 3 nights of PSD to 4 hours in bed per night [100]. No changes in monocytes, lymphocytes and CRP were reported.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [100] Boudjeltia KZ Faraut B Stenuit P Esposito MJ Dyzma M Brohee D Ducobu J Vanhaeverbeek M Kerkhofs M Sleep restriction increases white blood cells, mainly neutrophil count, in young healthy men: A pilot study Vascular Health and Risk Management 2008 4 1467 70 19337560 PMC2663438 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Cortisol levels appear to increase as a result of sleep loss and these elevated levels could exacerbate sleep disturbances.

    “In summary, cortisol levels appear to increase as a result of sleep loss and these elevated levels could exacerbate sleep disturbances.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A week of partial sleep deprivation from 8 hours in bed to 6 hours in bed for 7 nights showed elevated levels of 24-h IL-6 (p<0.01) and TNF-α (p<0.05), indicating a pro-inflammatory shift.

    “However, another study that included a week of PSD from 8 hours in bed to 6 hours in bed for 7 nights showed elevated levels of 24-h IL-6 (p<0.01) and TNF-α (p<0.05), indicating a pro-inflammatory shift [114].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [114] Vgontzas AN Adverse Effects of Modest Sleep Restriction on Sleepiness, Performance, and Inflammatory Cytokines The Journal of Clinical Endocrinology & Metabolism 2004 89 2119 26 15126529 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Sleep debt impacts many risk factors for CVD, including increased blood pressure, insulin resistance, obesity, unhealthy diet, and lower physical activity, as suggested by controlled sleep deprivation studies discussed previously.

    “Sleep debt impacts many of the risk factors for CVD, including increased blood pressure, insulin resistance, obesity, unhealthy diet, and lower physical activity as suggested by the controlled sleep deprivation studies discussed previously.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Although most epidemiologic studies are consistent with the laboratory studies, other studies did not observe a significant association between self-reported sleep duration and leptin levels.

    “Although most of these epidemiologic studies are consistent with the laboratory studies, other studies did not observe a significant association between self-reported sleep duration and leptin levels.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisereasoning

    Many studies observed higher mean BMI associated with longer sleep durations (generally >8 hours per night), indicating a U-shaped association between self-reported sleep duration and BMI where both short and long sleepers have higher average BMI.

    “Many of these studies also observed higher mean BMI associated with longer sleep durations (generally >8 hours per night), indicating a U-shaped association between self-reported sleep duration and BMI where both short and long sleepers have higher average BMI.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In the Cleveland Family Study of adults (average age 45), shorter total sleep time and less REM sleep were associated with higher leptin levels, while slow-wave sleep was not associated with leptin.

    “They found that shorter TST and less REM sleep was associated with higher leptin levels, while SWS was not associated with leptin [154].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [154] Hayes AL Xu F Babineau D Patel SR Sleep duration and circulating adipokine levels Sleep 2011 34 147 52 21286230 PMC3022933 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Sleep deprivation disturbs the circadian rhythm of immune cells, leading to disruptions of physiological rhythms that could lead to metabolic and endocrine consequences.

    “Sleep deprivation disturbs the circadian rhythm of the immune cells leading to disruptions of the physiological rhythms that could lead to metabolic and endocrine consequences.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Among persons with type 2 diabetes, poorer glycemic control is associated with worse sleep quality and increased sleep disordered breathing.

    “Furthermore, among persons with T2DM, poorer glycemic control is associated with worse sleep quality and increased sleep disordered breathing [179–181].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [179] Knutson KL Ryden AM Mander BA Van Cauter E Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus Arch Intern Med 2006 166 1768 74 16983057 source

      Not checked in the free run.

    • cites [180] Aronsohn RS Whitmore H Van Cauter E Tasali E Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes Am J Respir Crit Care Med 2010 181 507 13 20019340 PMC2830401 source

      Not checked in the free run.

    • cites [181] Knutson KL Van Cauter E Zee P Liu K Lauderdale DS Cross-sectional associations between measures of sleep and markers of glucose metabolism among subjects with and without diabetes: the Coronary Artery Risk Development in Young Adults (CARDIA) Sleep Study Diabetes Care 2011 34 1171 6 21411507 PMC3114508 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a study of adult women and men aged 19-45, greater nocturnal (dinner plus any late night snacks) intake of fat was associated with lower sleep efficiency, greater REM latency, higher percentage of N2, lower percentage of REM, and greater WASO after adjustment for age, gender, and socioeconomic status.

    “One study of adult women and men aged 19–45 years examined diet and sleep architecture using PSG and found that greater nocturnal (dinner plus any late night snacks) intake of fat was associated with lower sleep efficiency, greater REM latency, higher percentage of N2, lower percentage of REM and greater WASO after adjustment for age, gender, and socioeconomic status [161].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [161] Crispim CA Zimberg IZ dos Reis BG Diniz RM Tufik S de Mello MT Relationship between food intake and sleep pattern in healthy individuals J Clin Sleep Med 2011 7 659 64 22171206 PMC3227713 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a meta-analysis of 23 controlled laboratory studies in healthy participants, the effect on food intake was greatest for alcohol (Cohen's d = 1.03; 95% CI: 0.66, 1.4; P < 0.001), followed by sleep deprivation (Cohen's d = 0.49; 95% CI: 0.11, 0.88; P < 0.05).

    “Recently, a meta-analysis compared the effect of alcohol, sleep deprivation and TV watching on food intake using 23 controlled, laboratory studies in healthy participants and found that the effect was greatest for alcohol (Cohen’s d = 1.03; 95% CI: 0.66, 1.4; P , 0.001) followed by sleep deprivation (Cohen’s d = 0.49; 95% CI: 0.11, 0.88; P , 0.05) [176].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [176] Chapman C Benedict C Brooks S Schiöth H Lifestyle determinants of the drive to eat: a meta-analysis The American journal of clinical nutrition 2012 96 492 7 22836029 PMC3417212 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    One study did not find a significant association between sleep and incident diabetes.

    “Note that one study did not find a significant association between sleep and incident diabetes [194]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [194] Bjorkelund C Bondyr-Carlsson D Lapidus L Lissner L Mansson J Skoog I Bengtsson C Sleep disturbances in midlife unrelated to 32-year diabetes incidence: the prospective population study of women in Gothenburg Diabetes Care 2005 28 2739 44 16249549 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Habitual sleep loss could result in significant weight gain, and one pathway through which this could happen is increasing energy intake.

    “Thus, habitual sleep loss could result in significant weight gain and one pathway though which this could happen is increasing energy intake.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [176] Chapman C Benedict C Brooks S Schiöth H Lifestyle determinants of the drive to eat: a meta-analysis The American journal of clinical nutrition 2012 96 492 7 22836029 PMC3417212 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Dietary intake can impact sleep, and therefore the sleep-diet relationship may be bidirectional.

    “These results indicate that dietary intake can impact sleep and therefore the sleep-diet relationship may be bidirectional.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [161] Crispim CA Zimberg IZ dos Reis BG Diniz RM Tufik S de Mello MT Relationship between food intake and sleep pattern in healthy individuals J Clin Sleep Med 2011 7 659 64 22171206 PMC3227713 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Sleep disturbances among undergraduate students in Portugal were associated with more bulimic behavior and more social pressure to eat.

    “Sleep disturbances among undergraduate students in Portugal were associated with more bulimic behavior and more social pressure to eat [155].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [155] Soares MJ Macedo A Bos SC Maia B Marques M Pereira AT Gomes AA Valente J Nogueira V Azevedo MH Sleep disturbances, body mass index and eating behaviour in undergraduate students J Sleep Res 2011 20 479 86 20887393 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Dietary intake is associated with weight gain.

    “since dietary intake is associated with weight gain [175].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [175] Mozaffarian D Hao T Rimm EB Willett WC Hu FB Changes in diet and lifestyle and long-term weight gain in women and men N Engl J Med 2011 364 2392 404 21696306 PMC3151731 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In one study of adults aged 35-50 using wrist actigraphy, shorter sleep duration and lower sleep quality were both associated with higher blood pressure.

    “In one study that recorded wrist actigraphy among adults aged 35–50 years, shorter sleep duration and lower sleep quality were both associated with higher blood pressure [207].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [207] Knutson KL Van Cauter E Rathouz PJ Yan LL Hulley SB Liu K Lauderdale DS Association between sleep and blood pressure in midlife: the CARDIA sleep study Arch Intern Med 2009 169 1055 61 19506175 PMC2944774 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A few studies examined cardiovascular disease mortality in relation to self-reported sleep duration, but none found a significant association in fully adjusted models.

    “A few studies have examined cardiovascular disease mortality in relation to self-reported sleep duration, but none found a significant association in fully adjusted models [212–214].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [212] Mallon L Broman JE Hetta J Sleep complaints predict coronary artery disease mortality in males: a 12-year follow-up study of a middle-aged Swedish population J Intern Med 2002 251 207 16 11886479 source

      Not checked in the free run.

    • cites [213] Heslop P Smith G Metcalfe C Macleod J Hart C Sleep duration and mortality: the effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women Sleep Medicine 2002 3 305 14 14592192 source

      Not checked in the free run.

    • cites [214] Chien KL Chen PC Hsu HC Su TC Sung FC Chen MF Lee YT Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort Sleep 2010 33 177 84 20175401 PMC2817905 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In NHANES analysis, self-reported short sleep duration was associated with both self-reported chronic disease (e.g., obesity and hypertension) and objectively measured markers of chronic disease (e.g., obesity and hyperlipidemia).

    “Analysis of NHANES did find that self-reported short sleep duration was associated with both self-reported chronic disease (e.g. obesity and hypertension) as well as objectively-measured markers of chronic disease (e.g. obesity and hyperlipidemia) [204].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [204] Grandner MA Chakravorty S Perlis ML Oliver L Gurubhagavatula I Habitual sleep duration associated with self-reported and objectively determined cardiometabolic risk factors Sleep Medicine 2014 15 42 50 24333222 PMC3947242 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Coronary artery calcification is a predictor of the development of coronary heart disease.

    “which is a predictor of the development of coronary heart disease [210].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [210] King CR Knutson KL Rathouz PJ Sidney S Liu K Lauderdale DS Short sleep duration and incident coronary artery calcification JAMA 2008 300 2859 66 19109114 PMC2661105 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    There is some evidence that inadequate sleep is associated with cardiovascular disease and hypertension.

    “Overall, there is some evidence that inadequate sleep is associated with cardiovascular disease and hypertension, but more rigorous studies are required to fully understand whether inadequate sleep actually leads to cardiovascular disease.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisenone given

    Experimental studies have found associations between sleep restriction or sleep fragmentation and impairments in glucose metabolism, alterations in appetite regulation, and increased inflammation.

    “Experimental studies have found associations between sleep restriction or sleep fragmentation and impairments in glucose metabolism, alterations in appetite regulation, and increased inflammation, all of which would increase the risk of developing cardiometabolic disease.”
    Quote in the paperSubstantial claim
77 of 77

  • The paper relies on this without support.

    Self-reported sleep duration is sufficiently valid to support associations between sleep deficiency and cardiometabolic disease despite being only moderately associated with objectively-estimated sleep duration.

    “Self-reported sleep duration has been only moderately associated with objectively-estimated sleep duration [122, 123]. Nonetheless, numerous studies have observed consistent associations using subjective sleep assessments that support the findings of the laboratory studies; sleep deficiency appears to be associated with cardiometabolic disease.”

  • The paper relies on this without support.

    Findings from short-term experimental sleep restriction are relevant to chronic habitual sleep deficiency and the development of chronic cardiometabolic disease.

    “Experimental studies conducted in the controlled environment of the laboratory provide detailed information about physiological changes associated with sleep restriction or impairments in sleep quality. These studies, however, are brief, lasting only a few weeks. Chronic conditions like obesity, diabetes and CVD develop over longer periods of time and therefore we need to understand whether habit”

  • The paper relies on this without support.

    Prospective studies provide stronger evidence for a causal link between inadequate sleep and the development of cardiometabolic diseases.

    “Prospective studies provide stronger evidence for a causal link between inadequate sleep and the development of cardiometabolic diseases.”

  • The paper relies on this without support.

    People with impaired fasting glucose are considered to have pre-diabetes and are therefore at risk of developing type 2 diabetes.

    “People with IFG are considered to have “pre-diabetes” and therefore at risk of developing T2DM.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Experimental sleep loss, such as induced by circadian misalignment and social jet lag, reduces insulin sensitivity and induces inflammation.

    “For instance, experimental sleep loss, such as induced by circadian misalignment and social jet lag, reduces insulin sensitivity and induces inflammation (127), which may, in turn, modulate insulin sensitivity (128) and is a risk factor for cardiometabolic disturbance (129).”

    From Chronotype: Implications for Epidemiologic Studies on Chrono-Nutrition and Cardiometabolic Health (2019) · cites this paper as [127]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Dietary-intake claim conflicts with cited study title

    Minor

    The text cites study [164] as evidence that shorter sleep is associated with greater energy and carbohydrate intake, but the title of reference [164] says sleep deprivation is related to low intake of both.

  • Conflicting sleep-restriction durations for study [26]

    Minor

    The paper describes the restricted-sleep condition in study [26] as 5.5 hours in bed per night in one section and 4.5 hours in bed per night in another. Both descriptions compare it with 8.5 hours per night for two weeks.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Vgontzas, 1997, Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity, J Clin Endocrinol Metab, 82, 1313, 10.1210/jcem.82.5.3950 · DOI · Paper page
  2. Houyez, 1990, Sommeil et hypertension artérielle, Arch Mal Coeur Vaiss, 83, 1085

Cited by

Sorted by citations

Related

Authors
Rangaraj, V. R., & Knutson, K. L.
Affiliations
University of Chicago (US)
Corresponding author
Knutson, Kristen L.
ORCID
Venue
Sleep Medicine
Publisher
Elsevier BV
Published
2016-02
Volume
18
Pages
19-35
ISSN
1389-9457 (ISSN-L)
DOI
10.1016/j.sleep.2015.02.535
PMC
PMC4758899
OpenAlex
W2049504682
Semantic Scholar
06d5e159f97d835280ee69c32812eea0b737b428
Cited by
120
References
217
Citations by year
2026: 7 · 2025: 13 · 2024: 10 · 2023: 14 · 2022: 16 · 2021: 6 · 2020: 10 · 2019: 12 · 2018: 12 · 2017: 11 · 2016: 9
FWCI
16.07
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Sleep Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK095207, P30 DK020595)
  • National Institute for Occupational Safety and Health (R01OH009482)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Keywords
insufficient sleep, cardiometabolic disease, health disparities, sleep duration, sleep quality, obesity, diabetes mellitus, hypertension, cardiovascular disease, racial and ethnic disparities, socioeconomic status, insulin sensitivity, glucose metabolism, appetite regulation, immune function
MeSH terms
Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Humans, Male, Obesity, Risk Factors, Sleep Wake Disorders, Health Status Disparities

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review