Impact of Sleep and Circadian Disruption on Energy Balance and Diabetes: A Summary of Workshop Discussions

Arble, Deanna M.; Bass, Joseph; Behn, Cecilia Diniz; Butler, Matthew; Challet, Étienne; Czeisler, Charles A.; Depner, Christopher M.; Elmquist, Joel K.; Franken, Paul; Grandner, Michael A.; Hanlon, Erin C.; Keene, Alex C.; Joyner, Michael J.; Karatsoreos, Ilia N.; Kern, Philip A.; Klein, Samuel; Morris, Christopher J.; Pack, Allan I.; Panda, Satchidananda; Ptáček, Louis J.; Punjabi, Naresh M.; Sassone–Corsi, Paolo; Scheer, Frank A.J.L.; Saxena, Richa; Seaquest, Elizabeth R.; Thimgan, Matthew S.; Cauter, Eve Van; Wright, Kenneth P.

doi:10.5665/sleep.5226

Cited by 149 publications

(115 citation statements)

References 122 publications

(142 reference statements)

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“…Existing first-line drug therapies for metabolic disease and type 2 diabetes, such as the commonly used insulin sensitiser, metformin, are known to modulate molecular clock function in insulinsensitive tissues [166][167][168]. Sleep disturbances predispose individuals to obesity and diabetes, and obesity predisposes individuals to sleep disturbances, instigating a vicious cycle [18,169]. So what can we do about this?…”

Section: Therapeutic Agentsmentioning

confidence: 99%

“…Recent efforts have been made to differentiate the effects of circadian disruption or circadian misalignment from other forms of sleep disturbance [18,20,21,92]. Evidence from a clinical study of circadian disruption in controlled-laboratory conditions revealed that exposure to misalignment, as occurs during shift work or chronic jet lag, leads to hyperinsulinaemia, hyperleptinaemia and misaligned cortisol rhythms [21].…”

Section: Sleep Disturbance Circadian Disruption and Altered Glucosementioning

confidence: 99%

“…In both humans and rodents, there are robust daily rhythms of glucose tolerance and insulin sensitivity [8,12,13]. Disturbances of the sleep/wake cycle, reduced sleep duration/quality and altered sleep architecture can impair these rhythms, likely contributing to the development of metabolic disease [14][15][16][17][18]. Likewise, dissociation of activity/feeding patterns from internal rhythms of hormone release and metabolic function, known as 'environmental circadian disruption' or 'circadian misalignment', can also have negative impacts on metabolism [19,20].…”

Section: The Internal Timing System and Metabolic Dysfunctionmentioning

confidence: 99%

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Chronomedicine and type 2 diabetes: shining some light on melatonin

et al. 2016

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In mammals, the circadian timing system drives rhythms of physiology and behaviour, including the daily rhythms of feeding and activity. The timing system coordinates temporal variation in the biochemical landscape with changes in nutrient intake in order to optimise energy balance and maintain metabolic homeostasis. Circadian disruption (e.g. as a result of shift work or jet lag) can disturb this continuity and increase the risk of cardiometabolic disease. Obesity and metabolic disease can also disturb the timing and amplitude of the clock in multiple organ systems, further exacerbating disease progression. As our understanding of the synergy between the timing system and metabolism has grown, an interest has emerged in the development of novel clock-targeting pharmaceuticals or nutraceuticals for the treatment of metabolic dysfunction. Recently, the pineal hormone melatonin has received some attention as a potential chronotherapeutic drug for metabolic disease. Melatonin is well known for its sleep-promoting effects and putative activity as a chronobiotic drug, stimulating coordination of biochemical oscillations through targeting the internal timing system. Melatonin affects the insulin secretory activity of the pancreatic beta cell, hepatic glucose metabolism and insulin sensitivity. Individuals with type 2 diabetes mellitus have lower night-time serum melatonin levels and increased risk of comorbid sleep disturbances compared with healthy individuals. Further, reduced melatonin levels, and mutations and/or genetic polymorphisms of the melatonin receptors are associated with an increased risk of developing type 2 diabetes. Herein we review our understanding of molecular clock control of glucose homeostasis, detail the influence of circadian disruption on glucose metabolism in critical peripheral tissues, explore the contribution of melatonin signalling to the aetiology of type 2 diabetes, and discuss the pros and cons of melatonin chronopharmacotherapy in disease management.

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Section: Therapeutic Agentsmentioning

confidence: 99%

Section: Sleep Disturbance Circadian Disruption and Altered Glucosementioning

confidence: 99%

Section: The Internal Timing System and Metabolic Dysfunctionmentioning

confidence: 99%

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Chronomedicine and type 2 diabetes: shining some light on melatonin

et al. 2016

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“…Therefore, evaluation and treatment of sleep-disordered breathing may have potential to improve fertility in this population of women. Further, as sleep deprivation also impairs glucose homeostasis [5], adequate sleep duration may also be crucial in this setting.…”

Section: Polycystic Ovary Syndrome and Obstructive Sleep Apneamentioning

confidence: 99%

Sleep, Circadian Rhythms, and Fertility

Goldstein

Smith

2016

Curr Sleep Medicine Rep

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Adequate sleep is crucial for general health and wellbeing. Although the neuronal control of the reproductive axis and sleep-generating neurons share an anatomical location, little is known regarding the impact of sleep and circadian disruption on fertility in women. Animal models have established clear circadian control of the pre-ovulatory luteinizing hormone surge. Additionally, disruption of the circadian timing system by exposure to abnormal light-dark cycles or mutations of core clock genes results in diminished reproductive capacity in animals. Abnormalities in menstruation, fertility, and early pregnancy maintenance in female shift workers provide evidence for a role of circadian rhythms in the reproductive health of women. Reproductive hormones may modify sleep, and the relationship is bidirectional such that sleep disruption may alter the profile of reproductive hormone secretion. Therefore, sleep, apart from its circadian timing, may also have relevance in attaining pregnancy. Additionally, infertility is associated with psychological distress which may result in poor quality sleep. The interaction between psychological distress and disturbed sleep in reproduction has garnered minimal attention and may be a crucial factor to consider during the evaluation and treatment of infertility. This work reviews animal models and evidence in women that suggest a role for sleep and circadian rhythms in reproductive health and reveals areas that require future investigation.

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“…OSA has also been linked to metabolic syndrome, hypertension, stroke, and cancer. Animal models that mimic conditions of OSA show altered metabolic, inflammatory, and autonomic changes with associated autonomic risk (85). The impact of the circadian system on OSA is unclear, but it may influence apnea occurrence and duration in the early morning compared with late afternoon.…”

Section: Osamentioning

confidence: 99%

Timing Matters: Circadian Rhythm in Sepsis, Obstructive Lung Disease, Obstructive Sleep Apnea, and Cancer

et al. 2016

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Physiological and cellular functions operate in a 24-hour cyclical pattern orchestrated by an endogenous process known as the circadian rhythm. Circadian rhythms represent intrinsic oscillations of biological functions that allow for adaptation to cyclic environmental changes. Key clock genes that affect the persistence and periodicity of circadian rhythms include BMAL1/CLOCK, Period 1, Period 2, and Cryptochrome. Remarkable progress has been made in our understanding of circadian rhythms and their role in common medical conditions. A critical review of the literature supports the association between circadian misalignment and adverse health consequences in sepsis, obstructive lung disease, obstructive sleep apnea, and malignancy. Circadian misalignment plays an important role in these disease processes and can affect disease severity, treatment response, and survivorship. Normal inflammatory response to acute infections, airway resistance, upper airway collapsibility, and mitosis regulation follows a robust circadian pattern. Disruption of normal circadian rhythm at the molecular level affects severity of inflammation in sepsis, contributes to inflammatory responses in obstructive lung diseases, affects apnea length in obstructive sleep apnea, and increases risk for cancer. Chronotherapy is an underused practice of delivering therapy at optimal times to maximize efficacy and minimize toxicity. This approach has been shown to be advantageous in asthma and cancer management. In asthma, appropriate timing of medication administration improves treatment effectiveness. Properly timed chemotherapy may reduce treatment toxicities and maximize efficacy. Future research should focus on circadian rhythm disorders, role of circadian rhythm in other diseases, and modalities to restore and prevent circadian disruption.

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Impact of Sleep and Circadian Disruption on Energy Balance and Diabetes: A Summary of Workshop Discussions

Cited by 149 publications

References 122 publications

Chronomedicine and type 2 diabetes: shining some light on melatonin

Chronomedicine and type 2 diabetes: shining some light on melatonin

Sleep, Circadian Rhythms, and Fertility

Timing Matters: Circadian Rhythm in Sepsis, Obstructive Lung Disease, Obstructive Sleep Apnea, and Cancer

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