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Sleep. 2016 Sep 1;39(9):1691-700. doi: 10.5665/sleep.6094.

The Sleep/Wake Cycle is Directly Modulated by Changes in Energy Balance.

Author information

University of Cambridge Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science and the NIHR Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK.
Institute for Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden.
Department of Internal Medicine, University of Lübeck, Germany.



The rise in obesity has been paralleled by a decline in sleep duration in epidemiological studies. However, the potential mechanisms linking energy balance and the sleep/wake cycle are not well understood. We aimed to examine the effects of manipulating energy balance on the sleep/wake cycle.


Twelve healthy normal weight men were housed in a clinical research facility and studied at three time points: baseline, after energy balance was disrupted by 2 days of caloric restriction to 10% of energy requirements, and after energy balance was restored by 2 days of ad libitum/free feeding. Sleep architecture, duration of sleep stages, and sleep-associated respiratory parameters were measured by polysomnography.


Two days of caloric restriction significantly increased the duration of deep (stage 4) sleep (16.8% to 21.7% of total sleep time; P = 0.03); an effect which was entirely reversed upon free feeding (P = 0.01). Although the apnea-hypopnea index stayed within the reference range (< 5 events per hour), it decreased significantly from caloric restriction to free feeding (P = 0.03). Caloric restriction was associated with a marked fall in leptin (P < 0.001) and insulin levels (P = 0.002). The fall in orexin levels from baseline to caloric restriction correlated positively with duration of stage 4 sleep (Spearman rho = 0.83, P = 0.01) and negatively with the number of awakenings in caloric restriction (Spearman rho = -0.79, P = 0.01).


We demonstrate that changes in energy homeostasis directly and reversibly impact on the sleep/wake cycle. These findings provide a mechanistic framework for investigating the association between sleep duration and obesity risk.


caloric restriction; leptin; orexin; sleep

[Available on 2017-03-01]
[Indexed for MEDLINE]
Free PMC Article

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