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Sleep and the epidemic of obesity in children and adults

E Van Cauter, University of Chicago, Chicago, United States
K Knutson, University of Chicago, Chicago, 60637, United States

Correspondence: Kristen Knutson, Email: kknutson{at}health.bsd.uchicago.edu

Abstract

Sleep is an important modulator of neuroendocrine function and glucose metabolism in children as well as in adults. In recent years, sleep curtailment has become a hallmark of modern society with both children and adults having shorter bedtimes than a few decades ago. This trend for shorter sleep duration has developed over the same time period as the dramatic increase in the prevalence of obesity. There is rapidly accumulating evidence from both laboratory studies and epidemiologic studies to indicate that chronic partial sleep loss may increase the risk of obesity and weight gain. The present article reviews laboratory evidence indicating that sleep curtailment in young adults results in a constellation of metabolic and endocrine alterations, including decreased glucose tolerance, decreased insulin sensitivity, elevated sympatho-vagal balance, increased evening concentrations of cortisol, increased levels of ghrelin levels, decreased levels of leptin and increased hunger and appetite. We also review cross-sectional epidemiologic studies associating short sleep with increased body mass index and prospective epidemiologic studies that have shown an increased risk of weight gain and obesity in children and young adults who are short sleepers. Altogether, the evidence points to a possible role of decreased sleep duration in the current epidemic of obesity.