This article describes results of a very small observational study suggesting some tantalizing links between sleep and diabetes risk. But it’s probably fair to say that this article, although it pretty accurately reflects the proffered data and does a solid job of pointing out study limitations, may have served readers better by not being written. The notion that sleep deprivation is linked epidemiologically to temporary insulin resistance has been reported in animal and human observational studies for more than a decade. The confounding factors — obesity, overeating, sleep apnea — are well known. The scope of the study was acknowledged to be extremely limited and perhaps unmoored from what “might happen in reality,” and it appears that at best, the observational letter to the editor on which the article is based adds only two possible and very preliminary new pieces of information to what is known: it did control for calorie intake, but only over a very few weeks of observation; and there is a slim bit of evidence that “catch up” sleep after four nights of sleep deprivation may improve insulin sensitivity by 23 percent. In sum, although the article states correctly that the study “doesn’t prove that catching up on sleep will prevent diabetes” or that sleep deprivation actually does increase diabetes risk, it doesn’t add much beyond that of a decade of similar investigations.
Type 2 diabetes is indeed reaching epidemic proportions in the U.S., along with its major risk factors, obesity and metabolic syndrome. Readers of health news stories will in large numbers therefore be looking for anything that will help them prevent or reduce their risk of the disorder, particularly anything that doesn’t sound too hard to do, like getting more sleep. They may grasp at mattresses if not straws, however, even though the article goes to some lengths to lower expectations for individual risk. There is nothing in this story that should lead anyone to conclude that getting more sleep on a weekend will help them avoid diabetes risk factors, and the data for 19 healthy young men offer nothing to say about older, obese patients, women, or interactions with other important factors, including exercise, stress, and gender.
The cost of the ‘intervention’ (catching up on sleep) is what is at issue here, and that is ‘free’. So we’ll rule this Not Applicable.
Benefits are not quantified in a meaningful way. The story says, “insulin sensitivity had fallen by 23 percent and their bodies had started to produce extra insulin. But when researchers checked again after two nights of extended rest, the men’s insulin sensitivity, and the amount of insulin their bodies produced, had returned to normal.” A 23% drop sounds substantial, but was it clinically important? What were the absolute numbers? We think the story could have done more here to help readers understand what was observed and what it means.
Hard to imagine the “harms” of getting more sleep, so we’ll rate this Not Applicable.
The story includes some useful qualifiers regarding the quality of the study and what conclusions can be drawn:
The study doesn’t prove sleeping late every weekend can counter the ill effects of insufficient rest every other night of the week, Broussard cautioned.
And it doesn’t prove that catching up on sleep will prevent diabetes.
It also notes:
“The results from the present study are unlikely to be fully reflective of what may occur in persons who are older, overweight or obese, or have other potent risk factors for diabetes,” said James Gangwisch, a researcher at Columbia University who wasn’t involved in the study.
The story could have provided more detail about the subjects, the relationship between insulin resistance and sleep deprivation vs other lifestyle issues, and previous research showing similar results.
None here. Insulin resistance and type 2 diabetes are important public health problems.
The article did a good job, as noted earlier, of highlighting the limitations of the study, and quotes an outside researcher saying as much. Kudos!
This article would have been greatly strengthened if it had at least mentioned the lifestyle and other interventions that can indeed reduce the risk of Type 2 diabetes or its complications, including weight reduction, good diets, exercise and medications. The issue of detecting and addressing diabetes risk factors such as insulin resistance issues in children and teenagers also could have put this article in better perspective, with respect to the apparent young age of the subjects.
The availability of sleep is not in question.
The article did point out the calorie control part of the protocol, and the possibly novel notion that two days of non-deprived sleep can reverse the insulin resistance increase observed in the subjects. It is clear what this small study aimed to add to the science.
Since the story includes commentary from an independent expert, we can be sure it didn’t rely excessively on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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