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Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions

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Neli Tsereteli, Raphael Vallat, Juan Fernandez-Tajes, Linda M. Delahanty, Jose M. Ordovas, David A. Drew, Ana M. Valdes, Nicola Segata, Andrew T. Chan, Jonathan Wolf, Sarah E. Berry, Matthew P. Walker, Timothy D. Spector, Paul W. Franks

Original languageEnglish
Pages (from-to)356-365
Number of pages10
Issue number2
Early online date30 Nov 2021
Accepted/In press2021
E-pub ahead of print30 Nov 2021
PublishedFeb 2022

Bibliographical note

Funding Information: We thank the participants of the PREDICT1 study. We also thank the staff of Zoe Ltd., the Department of Twin Research and Genetic Epidemiology, and Massachusetts General Hospital and the Translational and Clinical Research Center for their tireless work in contributing to the running of the study and data collection. We thank Abbott for their support with using their CGMs. TDS, SEB, LMD and PWF are consultants to Zoe Ltd. (?Zoe?). JW is an employee of Zoe. MPW serves as a consultant for and has equity interest in Oura, Bryte, Shuni and StimScience. All other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. Funding Information: Open access funding provided by Lund University. This work was supported by Zoe Ltd. TwinsUK is funded by the Wellcome Trust, Medical Research Council, European Union, Chronic Disease Research Foundation (CDRF), Zoe Global Ltd. and the National Institute for Health Research (NIHR)-funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust in partnership with King’s College London. Funding Information: This study was supported by Zoe Ltd., Wellcome Trust and NIHR. The PREDICT trial was conducted as a collaboration between academic research scientists and Zoe Ltd., the latter of which is a health data science start-up that spun out of Kings College London. As such, some of the funding for the PREDICT trial was provided by Zoe Ltd., who also contributed to the design and implementation of the study protocol, as well as the processing, analysis and interpretation of data. PWF holds a European Research Council consolidator award (CoG-2015_681742_NASCENT). Publisher Copyright: © 2021, The Author(s).

King's Authors


Aims/hypothesis: Sleep, diet and exercise are fundamental to metabolic homeostasis. In this secondary analysis of a repeated measures, nutritional intervention study, we tested whether an individual’s sleep quality, duration and timing impact glycaemic response to a breakfast meal the following morning. Methods: Healthy adults’ data (N = 953 [41% twins]) were analysed from the PREDICT dietary intervention trial. Participants consumed isoenergetic standardised meals over 2 weeks in the clinic and at home. Actigraphy was used to assess sleep variables (duration, efficiency, timing) and continuous glucose monitors were used to measure glycaemic variation (>8000 meals). Results: Sleep variables were significantly associated with postprandial glycaemic control (2 h incremental AUC), at both between- and within-person levels. Sleep period time interacted with meal type, with a smaller effect of poor sleep on postprandial blood glucose levels when high-carbohydrate (low fat/protein) (pinteraction = 0.02) and high-fat (pinteraction = 0.03) breakfasts were consumed compared with a reference 75 g OGTT. Within-person sleep period time had a similar interaction (high carbohydrate: pinteraction = 0.001, high fat: pinteraction = 0.02). Within- and between-person sleep efficiency were significantly associated with lower postprandial blood glucose levels irrespective of meal type (both p < 0.03). Later sleep midpoint (time deviation from midnight) was found to be significantly associated with higher postprandial glucose, in both between-person and within-person comparisons (p = 0.035 and p = 0.051, respectively). Conclusions/interpretation: Poor sleep efficiency and later bedtime routines are associated with more pronounced postprandial glycaemic responses to breakfast the following morning. A person’s deviation from their usual sleep pattern was also associated with poorer postprandial glycaemic control. These findings underscore sleep as a modifiable, non-pharmacological therapeutic target for the optimal regulation of human metabolic health. Trial NCT03479866. Graphical abstract: [Figure not available: see fulltext.]

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