Gut microbiota composition and functionality are associated with REM sleep duration and continuous glucose levels

Context: Sleep disruption is associated with poorer glucose metabolic control and altered gut microbiota in animal models.

Objective: We aimed to evaluate the possible links among REM sleep duration, continuous glucose levels, and gut microbiota composition.

Design: This is an observational, prospective, real-life, cross-sectional case-control study.

Setting: Tertiary Hospital recruiting healthy volunteers.

Patients or Other Participants: One-hundred and eighteen (60 with obesity), middle-aged (39.1-54.8) subjects.

Intervention(s): Glucose variability and REM sleep duration were assessed by 10-day continuous glucose monitoring (CGM) (Dexcom G6®) and wrist-actigraphy (Fitbit Charge 3®), respectively

Main Outcome Measure(s):. Glucose variability was evaluated through standard deviation (SD), coefficient of variation (CV), and interquartile range (IQR). The percentage of time in range (% TIR), 126-139 mg/dL (TIR2), and 140-199 mg/dL (TIR3) were calculated. Shotgun metagenomics sequencing was applied to study gut microbiota taxonomy and functionality.

Results: Increased glycemic variability (SD, CV, and IQR) was observed among subjects with obesity in parallel to increased % TIR2 and % TIR3. REM sleep duration was independently associated with the % TIR3 (β=-0.339; p<0.001) and glucose variability (SD, β=-0.350; p<0.001). Microbial taxa from Christensenellaceae family (Firmicutes phylum) were positively associated with REM sleep and negatively with glucose continuous monitoring levels, while bacteria from Enterobacteriacea family and bacterial functions involved in iron metabolism showed opposite associations. 

Conclusions: Decreased REM sleep duration was independently associated with a worse glucose profile. The associations of species from Christensenellaceae and Enterobacteriaceae families with REM sleep duration and continuous glucose values suggest an integrated picture of metabolic health.