Sleep and the metabolic syndrome

Cardiovascular/Metabolic Diseases, Pfizer Global Research & Development, Eastern Point Road, MS 8260-2506, Groton, CT 06340, USA.
Experimental Physiology (Impact Factor: 2.67). 02/2007; 92(1):67-78. DOI: 10.1113/expphysiol.2006.033787
Source: PubMed


The metabolic syndrome represents a clustering of several interrelated risk factors of metabolic origin that are thought to increase cardiovascular risk. It is still uncertain whether this clustering results from multiple underlying risk factors or whether it has a single cause. One metabolic abnormality that may underlie several clinical characteristics of the metabolic syndrome is insulin resistance. This review discusses the evidence that sleep disturbances (obstructive sleep apnoea, sleep deprivation and shift work) may independently lead to the development of both insulin resistance and individual clinical components of the metabolic syndrome. The converse may also be true, in that metabolic abnormalities associated with the metabolic syndrome and insulin resistance may potentially exacerbate sleep disorders. The notion that sleep disturbances exert detrimental metabolic effects may help explain the increasing prevalence of the metabolic syndrome and insulin resistance in the general population and may have important implications for population-based approaches to combat the increasing epidemic of metabolic and cardiovascular disease.

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    • "It is thought that reductions in sleep quality results in longer exposure to elevated sympathetic nervous system activity and to waking physical and psychological stressors [2]. Consequently, there is growing evidence that significant correlations exist between poor sleep quality and the development of comorbid conditions including obesity, hypertension, diabetes mellitus, pain, and even death [2] [3] [4] [5] [6] [7] [8] [9]. "
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    ABSTRACT: Objective. Sleep disturbances are common in patients with carpal tunnel syndrome (CTS). This study investigates the impact of CTS on sleep quality and clarifies the magnitude of this relationship. Methods. This is a prospective investigation of patients with CTS. Patients responded to the Levine-Katz Carpal Tunnel and the Pittsburgh Sleep Quality Index (PSQI) questionnaires to assess symptom severity and quality, respectively. Descriptive and bivariate analyses summarized the findings and assessed the correlations between CTS severity and sleep quality parameters. Results. 66 patients (53F, 13M) were enrolled. Patients reported a sleep latency of 30.0 (±22.5) minutes, with a total sleep time of 5.5 (±1.8) hours nightly. Global PSQI score was 9.0 (±3.8); 80% of patients demonstrated a significant reduction in sleep quality (global PSQI score >5). Increased CTS symptom and functional severity both resulted in a significant reduction in quality and time asleep. Both significantly correlated with subjective sleep latency, sleep disturbance, use of sleep promoting medications, daytime dysfunction, and overall global PSQI score. Conclusions. The findings confirm the correlation of sleep disturbances to CTS, that is, significant reduction of sleep duration and a correlation to sleep quality. Patients sleep 2.5 hours less than recommended and are at risk for comorbid conditions.
    Full-text · Article · Feb 2014
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    • "There is a large association between shift work and the prevalence of many medical conditions – Wolk & Somers ( 2007 ) "

    Full-text · Dataset · Oct 2013
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    • "Some sleep deprivation studies have found that BP and sympathetic nervous system activity increased significantly after sleep restriction,15, 16, 42 and intervention study with melatonin (a hormone secreted at night that affects many physiological functions, including sleep) has been effective at reducing BP.17 Other contributing mechanisms may include overactivity of the renin-angiotensin-aldosterone system, proinflammatory responses, endothelial dysfunction, renal impairment43, 44 and alteration of the circadian rhythm.45 Sleep restriction has also been shown to compromise insulin sensitivity46 and to increase appetite by decreasing leptin and increasing ghrelin,47 which could eventually induce type 2 diabetes and obesity, both common risk factors for hypertension. "
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    ABSTRACT: To assess whether habitual sleep duration or insomnia increase the incidence of hypertension. PubMed, EMBASE and Cochrane were searched without language restriction. Prospective cohort studies of adults with at least a 1-year follow-up duration were included. Habitual sleep duration or symptoms of insomnia were assessed as baseline exposure, and the outcome was incidence of hypertension. Subgroup, meta-regression and sensitivity analyses were conducted to assess heterogeneity, and Egger's test was used to assess publication bias. Eleven studies (17 cohorts) were included. Short sleep duration, sleep continuity disturbance (SCD), early-morning awakening (EMA) and combined symptoms of insomnia increased the risk of hypertension incidence (the relative risks (95% confidence intervals) were 1.21 (1.05-1.40) for short sleep duration, 1.20 (1.06-1.36) for SCD, 1.14 (1.07-1.20) for EMA and 1.05 (1.01-1.08) for combined insomnia symptoms). Less evidence exists to support conclusions about the association between long sleep duration or difficulty falling asleep (DFA) and hypertension incidence. No obvious heterogeneity or publication biases were found. Our meta-analysis demonstrates that short sleep duration and single/combined symptoms of insomnia (except DFA) are associated with an increased risk of hypertension incidence. It is important to consider sleep duration and insomnia during hypertension prevention and treatment. More laboratory studies on potential mechanisms and prospective observational studies with objective measures of sleep are needed.Hypertension Research advance online publication, 5 September 2013; doi:10.1038/hr.2013.70.
    Full-text · Article · Sep 2013 · Hypertension Research
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