Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions

Authors: TSERETELI, NELI - Lund University; VALLAT, RAPHAEL - University Of California; FERNANDEZ-TAJES, JUAN - Lund University; DELAHANTY, LINDA - Harvard University; ORDOVAS, JOSE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; DREW, DAVID - Harvard University; VALDES, ANA - University Of Nottingham; SEGATA, NICOLA - University Of Trento, Italy; CHAN, ANDREW - Harvard University; WOLF, JONATHAN - Zoe Global Limited; BERRY, SARAH - King'S College; WALKER, MATTHEW - University Of California; SPECTOR, TIMOTHY - King'S College; FRANKS, PAUL - Lund University

Submitted to: Diabetologia
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/3/2021
Publication Date: 11/30/2021
Citation: Tsereteli, N., Vallat, R., Fernandez-Tajes, J., Delahanty, L.M., Ordovas, J.M., Drew, D.A., Valdes, A.M., Segata, N., Chan, A., Wolf, J., Berry, S.E., Walker, M.P., Spector, T.D., Franks, P.W. 2021. Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions. Diabetologia. 65:356-365. https://doi.org/10.1007/s00125-021-05608-y.
DOI: https://doi.org/10.1007/s00125-021-05608-y

Interpretive Summary: Sleep is the third pillar of health, along with diet and activity. We spend a third of our lives sleeping, and if that sleep is poor, it can trigger a cascade of health problems. The purpose of this work, conducted by an international team including investigators at the HNRCA in Boston, was to characterize to test whether an individual's sleep quality, duration, and timing impact blood glucose response to a breakfast meal the following morning. Data from healthy adults (N = 953 [41% twins]) from the PREDICT dietary intervention trial was used for this purpose. Poor sleep efficiency and later bedtime routines were associated with greater glucose responses to breakfast the following morning. Moreover, a person's deviation from their usual sleep pattern was also associated with poorer post-breakfast control of blood glucose. These findings underscore sleep as a modifiable, non-pharmacological therapeutic target for the optimal regulation of human metabolic health.

Technical Abstract: Aims/hypothesis: Sleep, diet and exercise are fundamental to metabolic homeostasis. In this secondary analysis of a repeated measures, nutritional intervention study, we tested whether an individual's sleep quality, duration and timing impact glycaemic response to a breakfast meal the following morning. Methods: Healthy adults' data (N = 953 [41% twins]) were analysed from the PREDICT dietary intervention trial. Participants consumed isoenergetic standardised meals over 2 weeks in the clinic and at home. Actigraphy was used to assess sleep variables (duration, efficiency, timing) and continuous glucose monitors were used to measure glycaemic variation (>8000 meals). Results: Sleep variables were significantly associated with postprandial glycaemic control (2 h incremental AUC), at both between- and within-person levels. Sleep period time interacted with meal type, with a smaller effect of poor sleep on postprandial blood glucose levels when high-carbohydrate (low fat/protein) (pinteraction = 0.02) and high-fat (pinteraction = 0.03) breakfasts were consumed compared with a reference 75 g OGTT. Within-person sleep period time had a similar interaction (high carbohydrate: pinteraction = 0.001, high fat: pinteraction = 0.02). Within- and between-person sleep efficiency were significantly associated with lower postprandial blood glucose levels irrespective of meal type (both p < 0.03). Later sleep midpoint (time deviation from midnight) was found to be significantly associated with higher postprandial glucose, in both between-person and within-person comparisons (p = 0.035 and p = 0.051, respectively). Conclusions/interpretation: Poor sleep efficiency and later bedtime routines are associated with more pronounced postprandial glycaemic responses to breakfast the following morning. A person's deviation from their usual sleep pattern was also associated with poorer postprandial glycaemic control. These findings underscore sleep as a modifiable, non-pharmacological therapeutic target for the optimal regulation of human metabolic health.