Influence of Nocturnal Light Exposure on the Impairment of Glucose Tolerance Induced by Chronic Sleep Restriction
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 14
- 试验地点
- 2
- 主要终点
- Impairment of Insulin Sensitivity
研究概览
简要总结
This project is designed to test for the first time whether glucose metabolism is differentially impaired by sleep restriction with and without additional exposure to artificial light at night (ALAN).
详细描述
Laboratory studies have shown that sleep restriction to 4-6h per night for durations varying from one to 14 days reduces glucose tolerance in otherwise healthy adults, but the mechanisms by which insufficient sleep impairs glucose metabolism are still unknown. Current theories are based on the premise that the adverse metabolic consequences are caused by reduction in the duration of sleep per se. However, sleep curtailment is typically accompanied by longer exposure to artificial light at night (ALAN), which is an environmental endocrine disrupter that profoundly disrupts circadian rhythms.
The investigators have previously reported that acute circadian misalignment induced hyperglycemia comparable to pre-diabetic states in a third of otherwise healthy participants. Since then, the investigators have shown that even when the circadian phase of participants was realigned, prior exposure to 2 ½ weeks of chronic sleep restriction combined with a history of recurrent circadian disruption induced even more deleterious effects on glucose metabolism, in which pancreatic beta cells failed to respond adequately to increased glucose levels. Moreover, both night and rotating shift work (which induce circadian disruption) are associated with increased risk for metabolic problems. Night shifts can lead to acute increases in glucose and insulin levels, although some studies report reduced insulin release in response to meals consumed during the night. Given that circadian disruption has been shown to independently adversely affect metabolism, and exposure to ALAN adversely impacts metabolism in animals, it is important to understand the extent to which circadian disruption contributes to the observed impact of sleep curtailment on metabolism. No previous studies of the metabolic impact of sleep restriction in humans have controlled for this additional exposure to ALAN, thus confounding the effects of sleep restriction with the effects of circadian disruption caused by extended exposure to ALAN.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Basic Science
- 盲法
- Single (Participant)
盲法说明
The order in which subjects undergo the two sleep interventions will be randomized.
入排标准
- 年龄范围
- 20 Years 至 40 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Healthy adults with conventional and regular sleep-wake timing
- •Non-smokers
- •Completion of medical, psychological, and sleep screening tests
- •Able to spend 33 consecutive days/nights in the laboratory
- •Normal color vision
排除标准
- •History of neurological or psychiatric disorder
- •History of sleep disorder or regular use of sleep-promoting medication
- •Current prescription, herbal, or over-the-counter medication use
- •Traveling across 2 or more time zones within past 3 months
- •Donating blood within past 8 weeks
- •Worked night or rotating shift work within past 3 years
- •Hearing impairment, visual impairment
- •History of eye trauma or surgery
- •Drug or alcohol dependency
结局指标
主要结局
Impairment of Insulin Sensitivity
时间窗: Change between Study Day 7 vs. Study Day 15 and Study Day 24 vs. Study Day 32
Insulin sensitivity (Si) is assessed via minimal model analysis, a mathematical model developed by Bergman and colleagues. Higher values represent better insulin sensitivity and lower values represent impaired insulin sensitivity. The mean change in Si between exposure and baseline is reported for each arm.
Impairment of Glucose Tolerance
时间窗: Change between Study Day 6 vs. Study Day 14 and Study Day 23 vs. Study Day 31
Test the hypothesis that exposure to one week of sleep restriction with concurrent exposure to extended duration ALAN (LD 19:5) will induce greater impairment of glucose tolerance than exposure to one week of sleep restriction without extended duration ALAN (LD 14:10). Glucose tolerance will be calculated as the area under the curve from minutes 0-120 following a mixed meal tolerance test
Impairment of Insulin Sensitivity
时间窗: Change between Study Day 7 vs. Study Day 15 and Study Day 24 vs. Study Day 32
Insulin sensitivity (Si) is assessed via minimal model analysis, a mathematical model developed by Bergman and colleagues. Higher values represent better insulin sensitivity and lower values represent impaired insulin sensitivity. The mean change in Si between exposure and baseline is reported for each arm.
Impairment of Glucose Tolerance
时间窗: Change between Study Day 6 vs. Study Day 14 and Study Day 23 vs. Study Day 31
Test the hypothesis that exposure to one week of sleep restriction with concurrent exposure to extended duration ALAN (LD 19:5) will induce greater impairment of glucose tolerance than exposure to one week of sleep restriction without extended duration ALAN (LD 14:10). Glucose tolerance will be calculated as the area under the curve from minutes 0-120 following a mixed meal tolerance test
Duration of Nocturnal Melatonin Secretion
时间窗: Change between Study Day 14-15 (overnight) vs. Study Day 31-32 (overnight)
Test the hypothesis that exposure to one week of sleep restriction with concurrent exposure to extended duration ALAN (LD 19:5) will acutely reduce the duration of nocturnal melatonin secretion as compared to baseline more than exposure to one week of sleep restriction without extended duration ALAN (LD 14:10). Duration of nocturnal melatonin secretion will be determined by the duration of time at which melatonin levels are above a threshold calculated as 25% of peak-to-trough amplitude at baseline in dim light.
次要结局
- Acute Insulin Response to Glucose(Change from study day 7 to 15 compared to change from study day 24 to 32)
- Glucose Effectiveness(Change from study day 7 to 15 vs change from study day 24 to 32)
- Insulin Area-under-the-curve(Change between Study Day 6 vs. Study Day 14 and Study Day 23 vs. Study Day 31)
- Duration of Endogenous Melatonin Secretory Profile(Study Day 15-16 vs Study Day 32-33)
研究者
Charles A. Czeisler, PhD, MD
Principal Investigator
Brigham and Women's Hospital