Sleep disorders and the development of insulin resistance and obesity.

Normal sleep is characterized both by reduced glucose turnover by the brain and other metabolically active tissues, and by changes in glucose tolerance. Sleep duration has decreased over the last several decades; data suggest a link between short sleep duration and type 2 diabetes. Obstructive sleep apnea (OSA) results in intermittent hypoxia and sleep fragmentation, and also is associated with impaired glucose tolerance. Obesity is a major risk factor for OSA, but whether OSA leads to obesity is unclear. The quality and quantity of sleep may profoundly affect obesity and glucose tolerance, and should be routinely assessed by clinicians.