COMMENTARY

Fractured Sleep Exacts a Heavy Toll

David A. Johnson, MD

Disclosures

February 19, 2014

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The Many Effects of Sleep Deprivation

Hello. I'm Dr. David Johnson, Professor of Medicine and Chief of Gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia.

Recently, I discussed the implications of sleep deprivation and inflammatory bowel disease, including the upregulation of proinflammatory cytokines, tumor necrosis factor (TNF) alpha, and factors that mediate toward potential relapse, even in patients with remission of inflammatory bowel disease. This suggests a causal link in recalcitrant disease as well as early relapse in patients who were deemed to be in clinical remission.

I want to continue that theme with a very provocative study that was just published in Cancer Research.[1] I will get to the relationship between sleep deprivation and tumor genesis and the acceleration of cancer tumors as it relates to several different cancers in a moment, but first, let's review sleep deprivation so that you understand what the literature shows to date.

Sleep deprivation has a profound impact on multiple disease states. For example, if you sleep less than 6 hours, epidemiologic studies show the following:

Stroke is increased by a factor of 4 times.

Obesity is increased by an increase in ghrelin, which is a hunger hormone.

Diabetes is increased because sleep deprivation increases insulin resistance.

Memory loss is accelerated. Epidemiologic studies show that there is not only permanent cognitive loss but also evidence of early brain deterioration.

Osteoporosis is increased, at least in an animal model, with changes in bone mineral density. Even changes in bone marrow are evident within 3 months of a study in a rat model.

Cardiac disease is increased. There is a 48% increase in early cardiac death, as well as increased cardiac-related mortality.

A 4-fold overall increase in mortality.

As it relates to gastrointestinal disease, there is an increased risk for colon cancer, and at least 1 epidemiologic study shows an association between sleep deprivation (or lack of sleep) and an increase in the likelihood of precancerous (adenomatous) polyps.

Now, let's take it a step further and look at a recent animal study published in Cancer Research.[1]

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