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Cited by 249Sleep and related disordersCircadian rhythm and melatoninSleep and Work-Related Fatigue

Metabolic effects of sleep disruption, links to obesity and diabetes

Open access
Nedeltcheva, Arlet V., Scheer, Frank A.J.L.·2014·Current Opinion in Endocrinology, Diabetes & Obesity
DOI 10.1097/med.0000000000000082PMC PMC4370346
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Abstract

PURPOSE OF REVIEW: To highlight the adverse metabolic effects of sleep disruption and to open ground for research aimed at preventive measures. This area of research is especially relevant given the increasing prevalence of voluntary sleep curtailment, sleep disorders, diabetes, and obesity. RECENT FINDINGS: Epidemiological studies have established an association between decreased self-reported sleep duration and an increased incidence of type 2 diabetes (T2D), obesity, and cardiovascular disease. Experimental laboratory studies have demonstrated that decreasing either the amount or quality of sleep decreases insulin sensitivity and decreases glucose tolerance. Experimental sleep restriction also causes physiological and behavioral changes that promote a positive energy balance. Although sleep restriction increases energy expenditure because of increased wakefulness, it can lead to a disproportionate increase in food intake, decrease in physical activity, and weight gain. SUMMARY: Sleep disruption has detrimental effects on metabolic health. These insights may help in the development of new preventive and therapeutic approaches against obesity and T2D based on increasing the quality and/or quantity of sleep.

AI snapshot

Written from the paper’s full text.

TL;DR

This review summarizes evidence that sleep disruption—short duration, poor quality, and circadian misalignment—impairs glucose regulation and promotes positive energy balance, linking sleep loss to obesity and type 2 diabetes. It highlights experimental human studies showing decreased insulin sensitivity, altered appetite hormones, increased energy expenditure that is often exceeded by increased intake, and calls for research on sleep extension as prevention or therapy.

Key findings

  • Epidemiologic studies associate self-reported sleep of less than 6–7 h per night with increased incidence of obesity, diabetes, cardiovascular disease, and total mortality; a 16-year longitudinal study found women sleeping ≤5 h gained 1.14 kg more than those sleeping 7 h per night, adjusted for age and BMI.
  • Experimental sleep restriction impairs glucose regulation: 4 h time in bed (TIB) for 6 nights decreased glucose tolerance by IVGTT; one night of 4 h vs. 8.5 h TIB decreased the glucose infusion rate by 25% in healthy subjects and by 21% in type 1 diabetes; 3 nights of 4 h vs. 9 h TIB increased HOMA-IR by 65% in adolescent boys.
  • Sleep restriction alters appetite hormones: 4 h TIB for 2 nights caused an 18% reduction in leptin, a 28% elevation in ghrelin, and a near 24% increase in hunger and appetite ratings with preference for calorie-dense, higher-carbohydrate food when caloric intake was kept constant.
  • Energy expenditure increases with sleep loss but may be smaller than intake increases: 40 h total sleep deprivation increased 24-h EE by 7%; 5 h vs. 9 h TIB for 5 nights increased daily EE by 5%, while food intake was 6% greater, resulting in weight gain; circadian misalignment in men decreased insulin sensitivity by 58% vs. 32% when aligned (P=0.01).

Methods

  • Narrative review of epidemiologic and experimental laboratory studies in humans, focusing on experimental work from the last 1–2 years and stated not to be exhaustive due to space limitations.
  • Synthesizes studies of sleep restriction, sleep deprivation, sleep fragmentation, obstructive sleep apnea/hypoxemia, and circadian misalignment, with outcomes including IVGTT, euglycemic hyperinsulinemic clamp, HOMA-IR, whole-room calorimetry, doubly labeled water, transcriptome analysis, and inflammatory markers.
  • No primary data collection or meta-analysis is described.

Limitations

  • Stated: epidemiologic studies cannot establish causation and typically rely on self-reported sleep duration; mechanisms are not well understood; the review is not exhaustive due to space limitation; and there is a paucity of research testing sleep extension or sleep improvement as a therapeutic approach.
  • Evident: as a narrative review, it lacks a systematic search or quantitative synthesis, and many experimental findings come from small, short-term laboratory samples (e.g., 13 healthy volunteers in the intermittent hypoxemia study), limiting generalization to chronic metabolic outcomes.

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Integrity signals

Registry

Crossref · 10.1097/med.0000000000000082

Cites

50 of 50 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 65 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    Epidemiological studies have established an association between decreased self-reported sleep duration and increased incidence of type 2 diabetes, obesity, and cardiovascular disease.

    “Epidemiological studies have established an association between decreased self-reported sleep duration and an increased incidence of type 2 diabetes (T2D), obesity, and cardiovascular disease.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [1] Taheri S The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity. Arch Dis Child 2006 91 11 881 4 17056861 PMC2082964 source

      Not checked in the free run.

    • cites [2] Watanabe M Association of short sleep duration with weight gain and obesity at 1-year follow-up: a large-scale prospective study. Sleep 2010 33 2 161 7 20175399 PMC2817903 source

      Not checked in the free run.

    • cites [3] Xiao Q A large prospective investigation of sleep duration, weight change, and obesity in the NIH-AARP Diet and Health Study cohort. Am J Epidemiol 2013 178 11 1600 10 24049160 PMC3842900 source

      Not checked in the free run.

  • Interpretationreasoning

    Sleep disruption has detrimental effects on metabolic health.

    “Sleep disruption has detrimental effects on metabolic health.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Findings from short-term laboratory sleep restriction studies generalize to long-term metabolic outcomes such as obesity and type 2 diabetes.
    • Rests on an assumption: Insulin sensitivity and glucose tolerance are valid surrogate markers for the risk of developing type 2 diabetes.
  • Interpretationreasoning

    Experimental sleep restriction causes physiological and behavioral changes that promote a positive energy balance.

    “Experimental sleep restriction also causes physiological and behavioral changes that promote a positive energy balance.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Effects of sleep restriction on energy balance observed in controlled laboratory settings translate to free-living weight gain.
  • Premisecitation

    Sleep restriction increases energy expenditure due to increased wakefulness.

    “While sleep restriction increases energy expenditure due to increased wakefulness, it can lead to a disproportionate increase in food intake, decrease in physical activity, and weight gain.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [38] Jung CM Energy expenditure during sleep, sleep deprivation and sleep following sleep deprivation in adult humans. J Physiol 2011 589 Pt 1 235 44 21059762 PMC3039272 source

      Not checked in the free run.

    • cites [39] source

      Not checked in the free run.

    • cites [40] Shechter A Experimental sleep curtailment causes wake-dependent increases in 24-h energy expenditure as measured by whole-room indirect calorimetry. The American journal of clinical nutrition 2013 98 6 1433 9 24088722 PMC3831535 source

      Not checked in the free run.

  • Premisecitation

    Sleep restriction can lead to a disproportionate increase in food intake.

    “While sleep restriction increases energy expenditure due to increased wakefulness, it can lead to a disproportionate increase in food intake, decrease in physical activity, and weight gain.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39] source

      Not checked in the free run.

  • May combine two claims. 15
  • Classified as probably not a substantial claim. 1

  • May combine two claims.

    Premisecitation

    Experimental laboratory studies have demonstrated that decreasing either the amount or quality of sleep decreases insulin sensitivity and decreases glucose tolerance.

    “Experimental laboratory studies have demonstrated that decreasing either the amount or quality of sleep decreases insulin sensitivity and decreases glucose tolerance.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [23] Spiegel K Leproult R Van Cauter E Impact of sleep debt on metabolic and endocrine function. Lancet 1999 354 9188 1435 9 10543671 source

      Not checked in the free run.

    • cites [24] Leproult R Sleep loss results in an elevation of cortisol levels the next evening. Sleep 1997 20 10 865 70 9415946 source

      Not checked in the free run.

    • cites [25] Van Cauter E Impact of sleep and sleep loss on neuroendocrine and metabolic function. Horm Res 2007 67 Suppl 1 2 9 17308390 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In epidemiologic work, short sleep has been associated with increased prevalence of type 2 diabetes, obesity, and cardiovascular disease.

    “In epidemiologic work, short sleep has been associated with an increased prevalence of type 2 diabetes (T2D), obesity, and cardiovascular disease [1],[2], [3] [4], [5] [6], [7] [8], [9].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [1] Taheri S The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity. Arch Dis Child 2006 91 11 881 4 17056861 PMC2082964 source

      Not checked in the free run.

    • cites [2] Watanabe M Association of short sleep duration with weight gain and obesity at 1-year follow-up: a large-scale prospective study. Sleep 2010 33 2 161 7 20175399 PMC2817903 source

      Not checked in the free run.

    • cites [3] Xiao Q A large prospective investigation of sleep duration, weight change, and obesity in the NIH-AARP Diet and Health Study cohort. Am J Epidemiol 2013 178 11 1600 10 24049160 PMC3842900 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Self-reported sleep of less than 6-7 h per night is associated with increased incidence of obesity, diabetes, cardiovascular disease, and total mortality risk.

    “Numerous epidemiological studies have shown that self-reported sleep of less than 6-7 h per night is associated with increased incidence of obesity [1],[2], [3]), diabetes [4], [5], cardiovascular disease [6], [7], and total mortality risk [8], [9].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [1] Taheri S The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity. Arch Dis Child 2006 91 11 881 4 17056861 PMC2082964 source

      Not checked in the free run.

    • cites [2] Watanabe M Association of short sleep duration with weight gain and obesity at 1-year follow-up: a large-scale prospective study. Sleep 2010 33 2 161 7 20175399 PMC2817903 source

      Not checked in the free run.

    • cites [3] Xiao Q A large prospective investigation of sleep duration, weight change, and obesity in the NIH-AARP Diet and Health Study cohort. Am J Epidemiol 2013 178 11 1600 10 24049160 PMC3842900 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    People with short sleep have lower leptin and higher ghrelin concentrations, independent of BMI.

    “Furthermore, cross-sectional observations of lower leptin and higher ghrelin concentrations in people with short sleep, independent of BMI, have led to the hypothesis that such hormonal changes promote over-eating and lead to increased risk of obesity [14], [15].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [14] Taheri S Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS medicine 2004 1 3 e62 15602591 PMC535701 source

      Not checked in the free run.

    • cites [15] Chaput JP Short sleep duration is associated with reduced leptin levels and increased adiposity: Results from the Quebec family study. Obesity 2007 15 1 253 61 17228054 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    Causation cannot be established from epidemiologic studies and results are typically based on self-reported sleep duration.

    “The main limitations are that causation cannot be established and results are typically based on self-reported sleep duration.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Observational studies show an association between OSA, narcolepsy, insomnia, and restless leg syndrome with insulin resistance and decreased glucose tolerance.

    “Observational studies have shown an association between OSA, narcolepsy, insomnia, and restless leg syndrome with insulin resistance and decreased glucose tolerance [22].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [22] Punjabi NM Do sleep disorders and associated treatments impact glucose metabolism? Drugs 2009 69 Suppl 2 13 27 20047348

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Partial sleep restriction to 4 h TIB for 2 nights causes an 18% reduction in leptin, a 28% elevation in ghrelin, and a near 24% increase in hunger and appetite ratings with preference for calorie-dense higher carbohydrate content food when caloric intake was kept constant.

    “Additionally, partial sleep restriction to 4 h TIB for 2 nights caused an 18% reduction in the anorexigenic hormone leptin, a 28% elevation in the orexigenic factor ghrelin, and a near 24% increase in hunger and appetite ratings with preference for calorie-dense higher carbohydrate content food when caloric intake was kept constant [31].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [31] Spiegel K Brief communication: 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 11 846 50 15583226 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Sleep curtailment for 14 nights to 5.5 h TIB vs 8.5 h TIB and for 5 nights to 4 h TIB vs 9 h TIB did not show significant differences in 24-h energy expenditure when measured by doubly labeled water.

    “When energy expenditure was measured by doubly labeled water technique, sleep curtailment for 14 nights to 5.5 h TIB (vs. 14 nights with 8.5 h TIB) [32] and for 5 nights to 4 h TIB (vs. 5 nights with 9 h TIB) [41] did not show significant differences in 24-h EE.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [32] Nedeltcheva AV Sleep curtailment is accompanied by increased intake of calories from snacks. Am J Clin Nutr 2009 89 1 126 33 19056602 PMC2615460 source

      Not checked in the free run.

    • cites [41] St-Onge MP Short sleep duration increases energy intakes but does not change energy expenditure in normal-weight individuals. The American journal of clinical nutrition 2011 94 2 410 6 21715510 PMC3142720 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the second study, food intake was 6% greater in sleep restricted compared to control condition, and increase in energy intake was larger than increase in energy expenditure, resulting in larger increase in body weight.

    “In the second study, food intake was 6% greater in the sleep restricted compared to control condition, i.e., the increase in energy intake was larger than the increase in EE, resulting in a larger increase in body weight [39]**.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Sleep restriction increases energy expenditure, but this increase appears smaller compared to increased energy intake when food is freely available.

    “While these three studies show that sleep restriction increases EE, this increase appears to be smaller compared to the increased energy intake when food is freely available.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Effects of sleep restriction on energy balance observed in controlled laboratory settings translate to free-living weight gain.

  • May combine two claims.

    Premisecitation

    Following two nights of sleep fragmentation, insulin sensitivity as assessed by IVGTT is decreased and morning cortisol is increased.

    “Following two nights of sleep fragmentation, insulin sensitivity as assessed by IVGTT was decreased and morning cortisol was increased [45].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [45] Stamatakis KA Punjabi NM Effects of sleep fragmentation on glucose metabolism in normal subjects. Chest 2010 137 1 95 101 19542260 PMC2803120 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    50-h total sleep deprivation causes an increase in TNF-alpha compared to baseline 8-h night, but no changes in interleukin-6, cortisol, or CRP.

    “Effect of sleep loss on inflammatory cytokines was evaluated in a study with 50-h total sleep deprivation, where sleep loss caused an increase in the pro-inflammatory cytokine TNF-alpha compared to a baseline 8-h night of sleep, but no changes in interleukin-6, cortisol, or CRP [43].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] Chennaoui M Effect of one night of sleep loss on changes in tumor necrosis factor alpha (TNF-alpha) levels in healthy men. Cytokine 2011 56 2 318 24 21737301 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Circadian misalignment induced by inversion of sleep/wake and fasting/feeding cycle by 12 h relative to central circadian pacemaker during forced desynchrony protocol increases postprandial plasma glucose despite increased insulin, decreases leptin, reduces sleep efficiency, and inverts cortisol and melatonin profiles.

    “Circadian misalignment induced by inversion of the sleep/wake and fasting/feeding cycle by 12 h relative to the timing of the central circadian pacemaker during a forced desynchrony protocol, increased postprandial plasma glucose despite increased insulin, decreased leptin, reduced sleep efficiency, and inverted the cortisol and melatonin profiles relative to the behavioral cycle [47].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [47] Scheer FA Adverse metabolic and cardiovascular consequences of circadian misalignment. Proc Natl Acad Sci U S A 2009 106 11 4453 8 19255424 PMC2657421

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Sleep curtailment alters energy expenditure, weight regulation, gene-expression, and inflammatory cytokine levels.

    “Sleep curtailment alters energy expenditure, weight regulation, gene-expression, and inflammatory cytokine levels.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Effects of sleep restriction on energy balance observed in controlled laboratory settings translate to free-living weight gain.

  • May combine two claims.

    Interpretationreasoning

    Hypoxia during OSA may increase the effect of sleep fragmentation on insulin sensitivity and contribute to development of diabetes.

    “Knowing that sleep fragmentation also impairs insulin sensitivity, hypoxia during OSA may increase that effect and contribute to development of diabetes.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Findings from short-term laboratory sleep restriction studies generalize to long-term metabolic outcomes such as obesity and type 2 diabetes.
    • Rests on an assumption: Insulin sensitivity and glucose tolerance are valid surrogate markers for the risk of developing type 2 diabetes.

  • May combine two claims.

    Interpretationreasoning

    Experimental sleep restriction alone or in combination with misalignment, and decreases in sleep quality negatively affect glucose regulation.

    “Experimental sleep restriction alone or in combination with misalignment, and decreases in sleep quality negatively affect glucose regulation.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Findings from short-term laboratory sleep restriction studies generalize to long-term metabolic outcomes such as obesity and type 2 diabetes.
    • Rests on an assumption: Insulin sensitivity and glucose tolerance are valid surrogate markers for the risk of developing type 2 diabetes.
16 of 16

  • The paper relies on this without support.

    Findings from short-term laboratory sleep restriction studies generalize to long-term metabolic outcomes such as obesity and type 2 diabetes.

    “These insights may help in the development of new preventative and therapeutic approaches against obesity and T2D based on increasing the quality and/or quantity of sleep.”

  • The paper relies on this without support.

    Insulin sensitivity and glucose tolerance are valid surrogate markers for the risk of developing type 2 diabetes.

    “Experimental sleep restriction alone or in combination with misalignment, and decreases in sleep quality negatively affect glucose regulation.”

  • The paper relies on this without support.

    Effects of sleep restriction on energy balance observed in controlled laboratory settings translate to free-living weight gain.

    “While sleep restriction increases energy expenditure due to increased wakefulness, it can lead to a disproportionate increase in food intake, decrease in physical activity, and weight gain.”
3 of 3

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?

  • In experimental studies, a combination of circadian misalignment and sleep restriction reduces insulin sensitivity, increases inflammation, and impairs glucose tolerance.

    “In experimental studies, a combination of circadian misalignment and sleep restriction has been shown to reduce insulin sensitivity (124), increase inflammation (112), and impair glucose tolerance (125).”

    From Chronotype: Implications for Epidemiologic Studies on Chrono-Nutrition and Cardiometabolic Health (2019) · cites this paper as [125]

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Authors
Nedeltcheva, A. V., & Scheer, F. A. J. L.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Nedeltcheva, Arlet V.
ORCID
Scheer, Frank A.J.L.
Venue
Current Opinion in Endocrinology, Diabetes & Obesity
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2014-08
Volume
21
Issue
4
Pages
293-298
ISSN
1752-296X (ISSN-L)
DOI
10.1097/med.0000000000000082
PMC
PMC4370346
OpenAlex
W2027098051
Semantic Scholar
f5b9a4da8793715cd5cff3654d4c4ff5432cc4b5
Cited by
249
References
50
Citations by year
2026: 11 · 2025: 15 · 2024: 19 · 2023: 14 · 2022: 22 · 2021: 27 · 2020: 27 · 2019: 29 · 2018: 33 · 2017: 15 · 2016: 25 · 2015: 8 · 2014: 4
FWCI
2.33
Type
journal article
Language
en
Open access
Locations
  • Current Opinion in Endocrinology Diabetes and Obesity (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Heart, Lung, and Blood Institute (R01HL094806)
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
sleep disruption, sleep restriction, sleep duration, type 2 diabetes, obesity, insulin sensitivity, glucose tolerance, energy balance, dietary intake, physical activity, cardiovascular disease, metabolic health, sleep quality
MeSH terms
Diabetes Mellitus, Type 2, Eating, Energy Metabolism, Humans, Insulin Resistance, Obesity, Risk Factors, Sleep Deprivation, Weight Gain

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