Chronic Insufficient Sleep Associated With Increased Insulin in Women

Chronic insufficient sleep is associated with increased insulin in woman, with this association more pronounced in postmenopausal women, according to a recent study published in Diabetes Care.¹

“Women report poorer sleep than men, so understanding how sleep disturbances impact their health across the lifespan is critical, especially for postmenopausal women,” said Marishka Brown, PhD, director of the National Center on Sleep Disorder Research at the National Heart, Lung, and Blood Institute (NHLBI).

While data has associated insufficient sleep with increased risks of hypertension, cardiovascular disease, and disordered glucose metabolism, a potential source of insulin resistance and type 2 diabetes, much of this data was performed on male participants or evaluated short-term sleep restriction.

Investigators conducted a study to evaluate the association between a reduction in sleep of 1.5 hours per night and blood glucose and insulin levels in women. As insulin regulates glucose in the body, insulin resistance in the body’s cells causes insulin to be less effective, significantly increasing prediabetes and type 2 diabetes risk.

Participants included women aged 20 to 75 years with healthy sleep patterns, normal fasting glucose levels, and elevated cardiovascular disease risk because of overweight or obesity, family history of type 2 diabetes, increased lipid in the blood, or cardiovascular disease. Healthy sleep patterns were defined as 7 to 9 hours of sleep per night.

Women wore a sensor on their wrist to monitor their sleep, beginning with a 2-week period of typical sleep patterns. Participants also kept nightly sleep logs during this period, establishing a baseline. Once the baseline was established, 2 6-week periods were completed in a random order.

One 6-week period included continuation of healthy sleep patterns, while another included restricted sleep. A 6-week break was completed by patients in between the 2 periods.

Participants slept for an average 7.5 hours during typical sleep period. During the restricted sleep period, falling asleep was delayed by 1.5 hours a night while waketime did not change. This led participants to sleep for an average 6.2 hours per night, which is the average sleep duration for adults in the United States with insufficient sleep.

Glucose and insulin blood levels were evaluated through an oral glucose tolerance test at the start and end of each study phase. Body composition was measured using a magnetic resonance imaging scan.

A 14.8% increase in insulin resistance was seen in both premenopausal and postmenopausal women with sleep restricted to 6.2 hours per night. These effects were more severe in postmenopausal women, with some having insulin resistance as high as 20.1%.

Fasting insulin levels rose in premenopausal woman, while fasting insulin and glucose rose in postmenopausal women. Notably, effects on insulin resistance were independent of body weight, and insulin and glucose levels returned to normal once women returned to 7 to 9 hours of sleep per night.

“What we’re seeing is that more insulin is needed to normalize glucose levels in the women under conditions of sleep restriction, and even then, the insulin may not have been doing enough to counteract rising blood glucose levels of postmenopausal women,” said Marie-Pierre St-Onge, PhD, director of the Center of Excellence for Sleep and Circadian Research at Columbia University Vagelos College of Physicians and Surgeons, New York City.

“If that's sustained over time, it is possible that prolonged insufficient sleep among individuals with prediabetes could accelerate the progression to type 2 diabetes.” St-Onge added.

This article originally appeared on Contemporary OB/GYN.

Reference

1. Chronic sleep deficiency increases insulin resistance in women, especially postmenopausal women. National Institutes of Health. November 14, 2023. Accessed November 17, 2023. https://www.nih.gov/news-events/news-releases/chronic-sleep-deficiency-increases-insulin-resistance-women-especially-postmenopausal-women