Abstract
Aims/hypothesisSleep, 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.MethodsHealthy 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).ResultsSleep 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/interpretationPoor 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.Trial registrationClinicalTrials.gov NCT03479866.Graphical abstract
Highlights
Diet, physical activity and sleep are increasingly recognised as core modifiable components of a healthy lifestyle
While there have been numerous large prospective cohort studies focused on the relationship between selfreported sleep, disease and wellbeing, objective data on sleep and postprandial glucose metabolism typically emanates from small studies conducted in tightly controlled settings and in specific population subgroups such as those suffering sleep disturbances owing to pregnancy, sleep apnoea, depression, obesity or diabetes [11]
We found no significant interactions between postprandial glucose and sex, meaning that there was no evidence to believe the results are different for the two sexes
Summary
Physical activity and sleep are increasingly recognised as core modifiable components of a healthy lifestyle. Sleep has direct causal effects on many life-threatening diseases such as CVD, obesity and type 2 diabetes [2,3,4,5]. Its disturbance (such as obstructive sleep apnoea) is associated with type 2 diabetes prevalence and complications [6] and can disrupt glucose homeostasis [7]. These and other data [8,9,10] point to a strong link between sleep quality/duration and glucose homeostasis. The evidence base for potential recommendations concerning the effects of sleep on glucose metabolism in generally healthy people has considerable scope for expansion
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