Health

What are the effects of sleep deprivation on leptin (“satiety hormone”) and ghrelin (“hunger hormone”)? With sleep deprivation, leptin decreases and ghrelin (from the original root ghre meaning “to grow”) increases. In longer than average sleep, leptin increases, and ghrelin decreases. It has been documented that leptin secretion is blunted in sleep-deprived subjects and that over a …

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Does the effective use of CPAP in OSA lead to weight loss? Results are not consistent on this matter. Some 30% of patients treated for OSA may have stable or even increased body weight, with two mechanisms having been implicated: (1) Decreased work of breathing with treated OSA translates to conservation of calories during sleep; …

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How well are providers in diabetes clinics screening their patients for OSA? What are good tools for screening by history and physical examination? A study of patients with diabetes, using a validated questionnaire to quantify OSA risk and sleepiness, revealed that 56% of patients reported snoring, 29% had fatigue upon awakening, and 34% reported feeling …

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With respect to causality, does the use of CPAP improve abnormal glucose metabolism parameters? Yes. This is seen in subjects without diabetes, in nonobese patients with diabetes, and in patients with poorly controlled diabetes. Caveat: In this body of work, the reader must discern from the trial whether or not there was a published measure of CPAP …

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What are the main mechanisms underlying the development of abnormal glucose metabolism in patients with OSA? The hallmark of OSA is airflow reduction, which is typically associated with intermittent hypoxemia, sleep fragmentation, and SNS stimulation. In animal studies, insulin sensitivity has been shown to vary with intermittent hypoxemia, independent of activation of the SNS. Additionally, …

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What sleep abnormalities are associated with abnormal glucose metabolism? Snoring, sleep duration, and OSA have all been linked to hyperglycemia and T2DM risk. a. Interestingly just snoring , in nonobese Asians and especially in those who are obese, has been independently associated with abnormal oral glucose tolerance tests and higher hemoglobin A 1c (HbA 1c ) levels. b. In epidemiologic studies, sleep …

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How does sleep deprivation influence glucose tolerance? In one study, after 1 week of sleeping 4 hours per night, there were increases in post-breakfast insulin resistance. During sleep restriction, glucose tolerance is nearly 40% worse compared with that in a group with sleep extension. Interestingly, it is first-phase insulin release that has been found to …

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