Effect of sleep restriction on insulin sensitivity and energy metabolism in postmenopausal women: A randomized crossover trial

Abstract

Objective The aim of this study was to investigate the effect of sleep restriction (SR) on insulin sensitivity and energy metabolism in postmenopausal women. Methods In a randomized crossover trial, 14 women underwent four nights of habitual sleep (HS, 100% normal sleep) and SR (60% of HS) while following a eucaloric diet. Outcomes included the following: (1) insulin sensitivity by hyperinsulinemic‐euglycemic clamp, defined as the glucose infusion rate (GIR); (2) resting metabolism and substrate oxidation by indirect calorimetry; and (3) glucose, insulin, and C‐peptide concentrations following a standard meal test. Results Nine postmenopausal women (mean [SD], age 59 [4] years, BMI 28.0 [2.6] kg/m2) were analyzed. Accelerometer‐determined total time in bed was 8.4 ± 0.6 hours during HS versus 5.0 ± 0.4 hours during SR (38% reduction, p < 0.0001). SR reduced low‐dose insulin GIR by 20% (HS: 2.55 ± 0.22 vs. SR: 2.03 ± 0.20 mg/kg/min; p = 0.01) and high‐dose insulin GIR by 12% (HS: 10.48 ± 0.72 vs. SR: 9.19 ± 0.72 mg/kg/min; p < 0.001). SR reduced fat oxidation during high‐dose insulin infusion (p < 0.01), and it did not alter resting energy metabolism. Conclusions Four nights of SR reduced insulin sensitivity and fat oxidation in postmenopausal women. These findings underscore the role of insufficient sleep in metabolic dysfunction following menopause. Larger trials investigating how sleep disturbances cause metabolic dysfunction during menopause are needed across all stages of menopause.

Sleep Apnea, Obesity, and Diabetes — an Intertwined Trio

“…Thus, optimal health may require addressing all three factors [ 60 ]. However, sleep health is often ignored despite its potential contributions to treatment of OSA, obesity, and T2DM [ 61 ]. We focus on four treatments in this section: Exercise: Aerobic exercise is known to have benefits for overall health.…”

Wake up! It's time to recognize the importance of sleep in metabolic health

“…On the other side of the energy balance equation, insight into a potential contribution of energy expenditure to weight‐related effects of sleep are provided in this special section. In one study among postmenopausal women, curtailing nightly sleep duration versus maintaining adequate sleep increased respiratory exchange ratio, representing a reduction in fat oxidation, in response to a high‐dose insulin infusion [13]. This result suggests that, if maintained, short sleep could lead to unfavorable changes in body composition, an effect seen in a longer‐term sleep‐restriction trial [14].…”