Sleep interventions and glucose metabolism: systematic review and meta-analysis
Abstract
Objective Sleep disturbances (insufficient or poor sleep quality) have been linked to abnormal glucose metabolism. This systematic review and meta-analysis aimed to explore the effects of behavioral and pharmacological sleep interventions on glucose metabolism.Methods Medline and Embase were used for systematic search. Studies reporting behavioral or pharmacological interventions in population with sleep disturbances, with measured outcomes of glucose metabolism and sleep parameters were selected.Results Twenty two studies were eligible for review (eight were conducted in people with type 2 diabetes). Studies were grouped into three types of intervention: sleep extension (n = 6), sleep education or cognitive behavioral therapy for insomnia (CBT-I, n = 6) and pharmacological interventions (n = 10). CBT-I and sleep education resulted in significantly improved self-reported sleep quality (Pittsburgh Sleep Quality Index, mean difference, MD, -1.31, 95% confidence interval (CI) -1.83, -0.80), non-significant reduction in hemoglobin A1c level (MD -0.35%, 95% CI -0.84, 0.13), and non-significant reduction in fasting glucose levels (MD -4.76 mg/dL, 95% CI -14.19, 4.67). Other studies were not eligible for meta-analysis due to heterogeneity of interventions or outcomes. Sleep extension was able to increase sleep duration by varying degrees in short sleepers, and five of six studies demonstrated relationships between the intervention and measures of insulin resistance. A majority of pharmacological intervention studies showed improved sleep but the effects on glucose metabolism were mixed.Conclusions Available sleep interventions were effective in improving sleep but the effects on glucose metabolism were inconclusive. Larger randomized studies with consistent outcome measurements are needed to demonstrate this potential causal relationship.
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Very few data exist to show that improving sleep (duration or quality) in individuals with disrupted sleep causes improvements in cardiometabolic health; existing studies are limited by small sample sizes and inconsistent outcome assessments.
“very few data exist to show that improving sleep (duration or quality) in individuals with disrupted sleep causes improvements in cardiometabolic health; existing studies are limited by small sample sizes and inconsistent outcome assessments.”
From The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review (2024) · cites this paper as [167]
Sleep extension and pharmacological treatments for sleep can improve sleep outcomes and possibly insulin resistance.
“There is also evidence that sleep extension and pharmacological treatments for sleep can improve sleep outcomes and possibly insulin resistance (443,445).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [445]
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- Authors
- Kothari, V., Cardona, Z., Chirakalwasan, N., Anothaisintawee, T., & Reutrakul, S.
- Affiliations
- University of Illinois Chicago (US)
- Thai Red Cross Society (TH)
- Mahidol University (TH)
- Corresponding author
- Reutrakul, Sirimon
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2021-02
- Volume
- 78
- Pages
- 24-35
- ISSN
- 1389-9457 (ISSN-L)
- OpenAlex
- W3113339824
- Cited by
- 86
- References
- 50
- Citations by year
- 2026: 16 · 2025: 15 · 2024: 19 · 2023: 12 · 2022: 19 · 2021: 5
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- sleep interventions, glucose metabolism, sleep disorders, type 2 diabetes, cognitive behavioral therapy for insomnia, sleep education, sleep extension, sleep quality, HbA1c, fasting blood glucose, insulin resistance, short sleepers
- MeSH terms
- Diabetes Mellitus, Type 2, Glucose, Humans, Sleep, Sleep Wake Disorders, Cognitive Behavioral Therapy
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