Effects of sleep manipulation on markers of insulin sensitivity: A systematic review and meta-analysis of randomized controlled trials

Poor sleep habits are associated with increased risk of developing type 2 diabetes. In this review and meta-analysis, we aimed to investigate the effects of sleep manipulation on markers of insulin sensitivity from randomized, controlled trials. Sleep manipulation was defined as reduction in sleep duration, sleep quality, and circadian misalignment. A systematic literature search was conducted in three databases and resulted in 35 eligible articles. The studies included interventions on sleep restriction (26 studies), slow wave sleep suppression and rapid eye movement sleep disturbance (2 studies), sleep fragmentation (2 studies), and circadian misalignment (5 studies). The meta-analysis included 21 sleep restriction studies. Sleep restriction reduced insulin sensitivity assessed by oral or intravenous glucose tolerance test and homeostatic model assessment of insulin resistance. Whole-body insulin sensitivity was also reduced after short sleep when measured by the hyperinsulinemic euglycemic clamp, but peripheral insulin sensitivity was not affected. In addition, circadian misalignment and slow wave sleep suppression negatively affected insulin sensitivity, while rapid eye movement sleep disturbance and sleep fragmentation had no effect. In summary, the studies indicated that duration, quality, and timing of sleep are essential for metabolic function and risk of type 2 diabetes.