Sleep restriction for 1 week reduces insulin sensitivity in healthy men.
Sleep restriction for 1 week reduces insulin sensitivity in healthy men.
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作者：
Buxton OM;Pavlova M;Reid EW;Wang W;Simonson DC;Adler GK
睡眠时间短与糖耐量受损和糖尿病风险增加有关。睡眠限制对胰岛素敏感性的影响尚未确定。这项研究测试了减少夜间睡眠时间会降低胰岛素敏感性的假设，并评估了药物莫达非尼的效果，该药物可以提高清醒时的警觉性。这项为期12天的住院综合临床研究包括20名健康男性(年龄20-35岁，体重指数20-30 kg/m2)。受试者在床上每晚10小时，共8个晚上，其中包括3个住院夜晚(睡眠充足条件)，然后在床上每晚5小时(睡眠限制条件)≥7个晚上。受试者在睡眠限制期间每天服用300毫克莫达非尼或安慰剂。控制饮食和活动。在每种情况的最后2天，我们通过静脉葡萄糖耐量试验(IVGTT)和正常血糖-高胰岛素钳夹检测糖代谢。测定唾液皮质醇、24小时尿儿茶酚胺和神经行为功能。限制睡眠后胰岛素敏感性降低(均值±SD)20±24%(P=0.001)，胰岛素分泌反应无明显变化。同样，限制睡眠后，钳夹评估的胰岛素敏感性降低了11±5.5%(P<；0.04)。睡眠限制使糖耐量降低，性情指数降低。莫达非尼治疗不影响这些结果。胰岛素敏感性的变化与唾液皮质醇(睡眠受限增加51±8%，P<；0.02)、尿儿茶酚胺或慢波睡眠的变化无关。睡眠限制(每晚5小时)一周显著降低胰岛素敏感性，这引发了人们对长期睡眠不足对与胰岛素抵抗相关的疾病过程的影响的担忧。
Short sleep duration is associated with impaired glucose tolerance and an increased risk of diabetes. The effects of sleep restriction on insulin sensitivity have not been established. This study tests the hypothesis that decreasing nighttime sleep duration reduces insulin sensitivity and assesses the effects of a drug, modafinil, that increases alertness during wakefulness. This 12-day inpatient General Clinical Research Center study included 20 healthy men (age 20–35 years and BMI 20–30 kg/m2). Subjects spent 10 h/night in bed for ≥8 nights including three inpatient nights (sleep-replete condition), followed by 5 h/night in bed for 7 nights (sleep-restricted condition). Subjects received 300 mg/day modafinil or placebo during sleep restriction. Diet and activity were controlled. On the last 2 days of each condition, we assessed glucose metabolism by intravenous glucose tolerance test (IVGTT) and euglycemic-hyperinsulinemic clamp. Salivary cortisol, 24-h urinary catecholamines, and neurobehavioral performance were measured. IVGTT-derived insulin sensitivity was reduced by (means ± SD) 20 ± 24% after sleep restriction (P = 0.001), without significant alterations in the insulin secretory response. Similarly, insulin sensitivity assessed by clamp was reduced by 11 ± 5.5% (P < 0.04) after sleep restriction. Glucose tolerance and the disposition index were reduced by sleep restriction. These outcomes were not affected by modafinil treatment. Changes in insulin sensitivity did not correlate with changes in salivary cortisol (increase of 51 ± 8% with sleep restriction, P < 0.02), urinary catecholamines, or slow wave sleep. Sleep restriction (5 h/night) for 1 week significantly reduces insulin sensitivity, raising concerns about effects of chronic insufficient sleep on disease processes associated with insulin resistance.