Obesity and sleep disturbances: The “chicken or the egg” question

Abstract

Obesity and sleep disturbances are common conditions in modern societies and accumulating evidence support a close bidirectional causal relationship between these two conditions. Indeed, from one side sleep loss seems to affect energy intake and expenditure through its direct effects on hormone-mediated sensations of satiety and hunger and through the influence on hedonic and psychological aspects of food consumption. Sleep deprived patients have been shown to experiment excessive daytime sleepiness, fatigue, and tiredness that, in a vicious circle, enhances physical inactivity and weight gain. On the other side, obesity is a well-known risk factor for several sleep disorders. This narrative review will discuss the main pathophysiological mechanisms that link sleep loss to obesity and metabolic syndrome with particular attention to the three most common sleep disorders (insomnia, obstructive sleep apnoea syndrome, restless leg syndrome).

The Case for Early Use of Glucagon-like Peptide-1 Receptor Agonists in Obstructive Sleep Apnea Patients with Comorbid Diabetes and Metabolic Syndrome

“…Another reported mechanism is increased stimulation of the renin-angiotensin-aldosterone system and aldosterone over-secretion. In addition, body mass index (BMI) is positively correlated with plasma aldosterone and angiotensinogen levels [ 14 ].…”

The Impact of Sleep-Disordered Breathing on Ghrelin, Obestatin, and Leptin Profiles in Patients with Obesity or Overweight

“…Although sleep duration is normal, a decrease in sleep efficiency occurs, and as a result, patients experience daytime symptoms such as drowsiness, fatigue, impaired concentration, and metabolic disturbances. Further consequences include stimulation of the sympathetic nervous system, increased inflammatory parameters, an increased risk of developing insulin resistance, hyperinsulinemia, and glycemic disturbances with a tendency toward hyperglycemia and abnormal glucose tolerance [ 8 , 9 ]. The prevalence of OSA ranges widely from 6% to as much as 49%, depending on the studied population and diagnostic criteria; however, it is thought that these data are under-reported [ 10 ].…”

Association between Objectively Measured Sedentary Behaviour and Sleep Quality in Japanese Adults: A Population-Based Cross-Sectional Study

“…Sedentary behaviour is associated with obesity, and obesity is reportedly associated with sleep disturbance [ 14 ]. Previous studies have analysed the association between sedentary behaviour and SQ by adjusting body mass index (BMI), considering it as a modifier for the aforementioned association.…”