From the Journals

Poor night’s sleep impairs glucose control the next morning


Going to bed later than usual and/or getting a poor night’s sleep are both associated with impaired glycemic response to breakfast the following morning in healthy adults, according to a multiple test-meal challenge study conducted over 14 days.

“Our data suggest that sleep duration, efficiency, and midpoint are important determinants of postprandial glycemic control at a population level,” Neil Tsereteli, MD, Lund University Diabetes Centre, Malmo, Sweden, and colleagues wrote in their article, published online Nov. 30, 2021, in Diabetologia.

“And [the results] suggest that one-size-fits-all sleep recommendations are suboptimal, particularly in the context of postprandial glycemic control, a key component of diabetes prevention,” they added.

Prior research on sleep quality and control of glucose lacking

Diet, exercise, and sleep are fundamental components of a healthy lifestyle; however, the role that sleep plays in affecting blood glucose control in generally healthy people has been studied little so far, the researchers wrote.

Sleep disorders can act as a measure of general health as they often occur alongside other health problems. Sleep quality also has a direct causal effect on many conditions such as cardiovascular disease, obesity, and type 2 diabetes. And disturbed sleep caused by conditions such as obstructive sleep apnea is associated with the prevalence of type 2 diabetes and risk of associated complications.

This and other evidence suggest a strong link between glucose regulation and the quality and duration of sleep.

Dr. Tsereteli and colleagues set out to examine this further in the Personalized Responses to Dietary Composition Trial 1, which involved 953 healthy adults who consumed standardized meals over 2 weeks in a clinic setting and at home.

“The meals were consumed either for breakfast or lunch in a randomized meal order and consisted of eight different standardized meals,” the researchers wrote.

Activity and sleep were monitored using a wearable device with an accelerometer. Postprandial blood glucose levels were measured using a continuous glucose monitor.

Sleep variables including quality, duration, and timing and their impact on glycemic response to breakfast the following morning, and were compared between participants and within each individual.

Better sleep efficiency, better glucose control

The study found that, although there was no significant association between length of sleep period and postmeal glycemic response, there was a significant interaction when the nutritional content of the breakfast meal was also considered.

Longer sleep periods were associated with lower blood glucose following high-carbohydrate and high-fat breakfasts, indicating better blood glucose control.

Additionally, the researchers observed a within-person effect in which a study participant who slept for longer than they typically would was likely to have reduced postprandial blood glucose following a high-carbohydrate or high-fat breakfast the next day.

The authors also found a significant link between sleep efficiency (ratio of time asleep to total length of sleep period) and glycemic control. When a participant slept more efficiently than usual, their postprandial blood glucose also tended to be lower than usual.

“This effect was largely driven by sleep onset (going to bed later) rather than sleep offset (waking up later),” Dr. Tsereteli and colleagues noted.


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