Effects of Disordered Sleep on Metabolic Indicators: A Combined and Updated Meta-analysis

Effects of Disordered Sleep on Metabolic Indicators: A Combined and Updated Meta-analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effects of Disordered Sleep on Metabolic Indicators: A Combined and Updated Meta-analysis Lingzhuo Kong, Huaizhi Wang, Ruiqi Sang, Yubin Sun, Yuru Tang, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9056648/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Disordered sleep constitutes a global public health challenge and is closely associated with metabolic dysfunction, demanding a comprehensive quantitative assessment across the full spectrum of disorders and metabolic profiles. Methods A combined meta-analysis was performed including 45 eligible studies published before October 15th, 2025, identified through systematic searches of six publication database. Subgroup analysis additionally examined the influence of four parameters. The PROSPERO registration number is CRD420251168186. Results Compared to controlled individuals, participants with sleep apnea showed significantly elevated body mass index (SMD = 0.58, 95% CI 0.35–0.82), fasting glucose (SMD = 0.40, 95% CI 0.26–0.55), LDL (SMD = 0.25, 95% CI 0.08–0.41), and total cholesterol (SMD = 0.18, 95% CI 0.02–0.35), with particularly pronounced effects in elder individuals in Asian and North American populations. Sleep extension demonstrated protective effects on fasting glucose (RR = -1.16, 95%CI -1.84–0.48) and LDL (RR = 0.25, 95% CI 0.08–0.41). Little difference was observed between states before and after sleep intervention, while leptin levels increased significantly among male-dominant participants with sleep intervention (RR = 0.90, 95% CI 0.05–1.76). Effects of narcolepsy and idiopathic hypersomnia on metabolism remained uncertain. Significant heterogeneity, publication bias, and high bias of quality were determined in several studies, yet few changes after elimination and re-analyses were observed, possibly due to the general robustness and limited number of included studies. Conclusion Disordered sleep could adversely affect multiple metabolic indicators, and standardized, multi-ethnic, and multi-center cohorts are in need to further address such effects and detailed mechanism. Disordered sleep Metabolism Network meta-analysis Planar meta-analysis Full Text Additional Declarations No competing interests reported. Figures are available in the Supplementary Files section. Supplementary Files FigureLegends.docx Figure.pdf SupplementaryAppendix2.3.doc SupplementaryAppendix1.doc SupplementaryAppendix2.2.pdf SupplementaryAppendix6.doc SupplementaryAppendix4.doc SupplementaryAppendix3.doc SupplementaryAppendix5.doc Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 11 May, 2026 Reviewers agreed at journal 15 Apr, 2026 Reviewers invited by journal 02 Apr, 2026 Editor invited by journal 10 Mar, 2026 Editor assigned by journal 10 Mar, 2026 Submission checks completed at journal 10 Mar, 2026 First submitted to journal 07 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9056648","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":618713105,"identity":"6c82d033-164b-4d78-9365-2157ab31766f","order_by":0,"name":"Lingzhuo Kong","email":"","orcid":"","institution":"Shandong Provincial Hospital","correspondingAuthor":false,"prefix":"","firstName":"Lingzhuo","middleName":"","lastName":"Kong","suffix":""},{"id":618713106,"identity":"bbcb79dd-ff31-4128-911e-dc5b62beaeea","order_by":1,"name":"Huaizhi Wang","email":"","orcid":"","institution":"Beijing Anding 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Meta-analysis","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Disordered sleep, Metabolism, Network meta-analysis, Planar meta-analysis","lastPublishedDoi":"10.21203/rs.3.rs-9056648/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9056648/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDisordered sleep constitutes a global public health challenge and is closely associated with metabolic dysfunction, demanding a comprehensive quantitative assessment across the full spectrum of disorders and metabolic profiles.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA combined meta-analysis was performed including 45 eligible studies published before October 15th, 2025, identified through systematic searches of six publication database. Subgroup analysis additionally examined the influence of four parameters. The PROSPERO registration number is CRD420251168186.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eCompared to controlled individuals, participants with sleep apnea showed significantly elevated body mass index (SMD\u0026thinsp;=\u0026thinsp;0.58, 95% CI 0.35\u0026ndash;0.82), fasting glucose (SMD\u0026thinsp;=\u0026thinsp;0.40, 95% CI 0.26\u0026ndash;0.55), LDL (SMD\u0026thinsp;=\u0026thinsp;0.25, 95% CI 0.08\u0026ndash;0.41), and total cholesterol (SMD\u0026thinsp;=\u0026thinsp;0.18, 95% CI 0.02\u0026ndash;0.35), with particularly pronounced effects in elder individuals in Asian and North American populations. Sleep extension demonstrated protective effects on fasting glucose (RR = -1.16, 95%CI -1.84\u0026ndash;0.48) and LDL (RR\u0026thinsp;=\u0026thinsp;0.25, 95% CI 0.08\u0026ndash;0.41). Little difference was observed between states before and after sleep intervention, while leptin levels increased significantly among male-dominant participants with sleep intervention (RR\u0026thinsp;=\u0026thinsp;0.90, 95% CI 0.05\u0026ndash;1.76). Effects of narcolepsy and idiopathic hypersomnia on metabolism remained uncertain. Significant heterogeneity, publication bias, and high bias of quality were determined in several studies, yet few changes after elimination and re-analyses were observed, possibly due to the general robustness and limited number of included studies.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eDisordered sleep could adversely affect multiple metabolic indicators, and standardized, multi-ethnic, and multi-center cohorts are in need to further address such effects and detailed mechanism.\u003c/p\u003e","manuscriptTitle":"Effects of Disordered Sleep on Metabolic Indicators: A Combined and Updated Meta-analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-09 00:03:58","doi":"10.21203/rs.3.rs-9056648/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-11T21:23:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"310946856716594976638008499225604449043","date":"2026-04-15T08:59:08+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-02T17:15:01+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-10T15:56:04+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-10T10:37:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-10T10:37:12+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychiatry","date":"2026-03-07T07:56:37+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"997149b5-67d0-4e31-9a6f-3e18bcf0b054","owner":[],"postedDate":"April 9th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-11T21:23:34+00:00","index":65,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-09T00:03:58+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-09 00:03:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9056648","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9056648","identity":"rs-9056648","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}