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BIOLOGICAL SCIENCES / NEUROSCIENCE
Slow-wave sleep and the risk of type 2 diabetes in humans

Esra Tasali^*, Rachel Leproult, David A. Ehrmann, and Eve Van Cauter

Department of Medicine, University of Chicago, Chicago, IL 60637

Edited by Donald F. Steiner, University of Chicago, Chicago, IL, and approved November 9, 2007 (received for review July 10, 2007)

There is convincing evidence that, in humans, discrete sleep stages are important for daytime brain function, but whether any particular sleep stage has functional significance for the rest of the body is not known. Deep non-rapid eye movement (NREM) sleep, also known as slow-wave sleep (SWS), is thought to be the most "restorative" sleep stage, but beneficial effects of SWS for physical well being have not been demonstrated. The initiation of SWS coincides with hormonal changes that affect glucose regulation, suggesting that SWS may be important for normal glucose tolerance. If this were so, selective suppression of SWS should adversely affect glucose homeostasis and increase the risk of type 2 diabetes. Here we show that, in young healthy adults, all-night selective suppression of SWS, without any change in total sleep time, results in marked decreases in insulin sensitivity without adequate compensatory increase in insulin release, leading to reduced glucose tolerance and increased diabetes risk. SWS suppression reduced delta spectral power, the dominant EEG frequency range in SWS, and left other EEG frequency bands unchanged. Importantly, the magnitude of the decrease in insulin sensitivity was strongly correlated with the magnitude of the reduction in SWS. These findings demonstrate a clear role for SWS in the maintenance of normal glucose homeostasis. Furthermore, our data suggest that reduced sleep quality with low levels of SWS, as occurs in aging and in many obese individuals, may contribute to increase the risk of type 2 diabetes.

aging | sleep quality | sleep disordered breathing | delta waves | insulin resistance

The authors declare no conflict of interest.

This article is a PNAS Direct Submission.

This article contains supporting information online at www.pnas.org/cgi/content/full/0706446105/DC1.

*To whom correspondence should be addressed at: Department of Medicine, MC 6026, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637. E-mail: etasali{at}medicine.bsd.uchicago.edu

© 2008 by The National Academy of Sciences of the USA

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This article has been cited by other articles in HighWire Press-hosted journals:

				E. Tasali, B. Mokhlesi, and E. Van Cauter Obstructive Sleep Apnea and Type 2 Diabetes: Interacting Epidemics Chest, February 1, 2008; 133(2): 496 - 506. [Abstract] [Full Text] [PDF]

				D.-J. Dijk Slow-wave sleep, diabetes, and the sympathetic nervous system PNAS, January 29, 2008; 105(4): 1107 - 1108. [Full Text] [PDF]

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