Irregular Sleep Patterns Linked To Metabolic Disorders

Deviating from a regular bedtime and wakeup schedule – and getting different amounts of sleep each night – can put a person at higher risk for obesity, high cholesterol, hypertension, high blood sugar and other metabolic disorders, a new study has found. Furthermore, for every hour of variability in time to bed and time asleep, a person may have up to a 27% greater chance of experiencing a metabolic abnormality.

“Many previous studies have shown the link between insufficient sleep and higher risk of obesity, diabetes, and other metabolic disorders. But we didn’t know much about the impact of irregular sleep, high day-to-day variability in sleep duration and timing. Our research shows that, even after considering the amount of sleep a person gets and other lifestyle factors, every one-hour night-to-night difference in the time to bed or the duration of a night’s sleep multiplies the adverse metabolic effect,”

said study author Tianyi Huang, Sc.D., epidemiologist of the Channing Division of Network Medicine at Brigham and Women’s Hospital, Boston.

Future Metabolic Abnormalities

The researchers followed 2,003 men and women, ages 45 to 84, participating in the National Heart, Lung, and Blood Institute-funded Multi-Ethnic Study of Atherosclerosis (MESA). The participants were studied for a median of six years to find out the associations between sleep regularity and metabolic abnormalities.

To ensure objective measurement of sleep duration and quality, participants wore actigraph wrist watches to closely track sleep schedules for seven consecutive days. They also kept a sleep diary and responded to standard questionnaires about sleep habits and other lifestyle and health factors.

Participants completed the actigraphy tracking between 2010 and 2013 and were followed until 2016 and 2017.

“Objective metrics and a big and diverse sample size are strengths of this study. As is the study’s ability to look not only at current factors, but to conduct a prospective analysis that allowed us to assess whether patterns of irregular sleep could be linked to future metabolic abnormalities,”

said Michael Twery, Ph.D., director of the NHLBI’s National Center on Sleep Disorders Research.

Causal Link Evidence

The researchers’ hypothesis that there were, in fact, such associations, proved correct.

Individuals with greater variations in their bedtimes and in the hours they slept had a higher prevalence of metabolic problems, and these associations persisted after adjusting for average sleep duration. This was also the case when they looked at the participants who developed metabolic disorders during the 6.3 years of follow up.

The prospective results showed that the variations in sleep duration and bedtimes preceded the development of metabolic dysfunction. According to the authors, this provides some evidence supporting a causal link between irregular sleep and metabolic dysfunction.

Participants whose sleep duration varied more than one hour were more likely to be African-Americans, work non-day shift schedules, smoke, and have shorter sleep duration. They also had higher depressive symptoms, total caloric intake, and index of sleep apnea.

Increasing sleep duration or bedtime variability was strongly associated with multiple metabolic and simultaneous problems such as lower HDL cholesterol and higher waist circumference, blood pressure, total triglycerides, and fasting glucose.

“Our results suggest that maintaining a regular sleep schedule has beneficial metabolic effects. This message may enrich current prevention strategies for metabolic disease that primarily focus on promoting sufficient sleep and other healthy lifestyles,”

said study coauthor Susan Redline, M.D., senior physician in the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital.

Tianyi Huang, Susan Redline
Cross-sectional and Prospective Associations of Actigraphy-Assessed Sleep Regularity With Metabolic Abnormalities: The Multi-Ethnic Study of Atherosclerosis
Diabetes Care 2019 May; dc190596. https://doi.org/10.2337/dc19-0596

Image: NHLBI