Sleep and the epidemic of obesity in children and adults

DOI: 10.1530/EJE-08-0298
European Journal of Endocrinology, Vol 159, suppl_1, S59-S66
Copyright © 2008 by European Society of Endocrinology

Sleep and the epidemic of obesity in children and adults
Eve Van Cauter1 and Kristen L Knutson2

Departments of1 Medicine, MC10272 Health Studies, University of Chicago, 5841 S. Maryland Avenue Chicago, Illinois 60637, USA

(Correspondence should be addressed to E Van Cauter; Email: evcauter@medicine.bsd.uchicago.edu)

This paper was presented at the 5th Ferring International Paediatric Endocrinology Symposium, Baveno, Italy (2008). Ferring Pharmaceuticals has supported the publication of these proceedings.

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 and epidemiological 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 sympathovagal balance, increased evening concentrations of cortisol, increased levels of ghrelin, decreased levels of leptin, and increased hunger and appetite. We also review cross-sectional epidemiological studies associating short sleep with increased body mass index and prospective epidemiological 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.