Lancet Diabetes & Endocrinology has published a review of sleep deprivation and metabolism, co-authored by Dr. Schmid, University of Lübeck, Germany, Dr. Hallschmid, University of Cambridge, and Dr. Schultes, eSwiss Medical and Surgical Center. The review suggests that short sleep duration, sleep disorders, and physiological rhythms out of sync are associated with metabolic disorders, such as obesity and type 2 diabetes, and recommends that sleep issues be taken seriously. The authors emphasize the importance of identifying “patients at risk” in advance of sleep interventions. For example, patients can be screened using simple and easy-to-use assessments such as the Pittsburgh Sleep Quality Index. Dr. Schmid et al. note that given the current high prevalence and increasing trend of sleep disorders, treatment of low-quality sleep should be considered as a potential metabolic risk factor for patients, and awareness should be raised among medical staff. Asking patients about their sleep status is critical, and lifestyle monitoring via technological devices may provide more objective data. Lifestyle triggers metabolic disorders This review notes that large epidemiological and observational studies since 1990 have suggested a correlation between low quality sleep and metabolic disorders. Also, there are research trials suggesting that poor sleep quality leads to insulin tolerance and increased consumption of high-energy diets. Circadian rhythm disorders combined with sleep duration restriction can further exacerbate the effects of sleep quality on metabolism. Although the correlation between sleep and metabolism is multifactorial, hormonal pathways (e.g., the hypothalamic-pituitary-adrenal adrenocortical axis), the autonomic nervous system, and other related mechanisms also contribute to the interaction between the two. In addition to the “classical biochemical” pathways, changes in behavioral habits such as physical exercise and dietary choices are also associated with sleep treatment and energy balance. The authors also focus on the 24-hour lifestyle, with video games, online shopping, social networking, and television viewing as risk factors for sleep disruption. Among the adolescent population, computer games and electronic social media are the main causes of reduced sleep. Although it is not possible to confirm whether improved sleep quality improves diabetes symptoms, improved sleep quality is certainly an indicator of treatment and improvement of the metabolic syndrome. The article also cites two large cohort studies that shed light on shift workers and their metabolic problems. In a study of 1811 aviation personnel, the incidence of metabolic syndrome was 2.13 times higher in shift workers than in day workers. In addition, a survey of 26,463 Chinese shift retirees showed significantly higher rates of hypertension, diabetes, and self-reported low sleep quality in this group. For shift workers, they are not immune to sleep restriction and circadian rhythm asynchrony, but interventions can be effective in promoting sleep quality in this group. The authors concluded that improving sleep quality through sleep education programs and cognitive behavioral therapy to achieve metabolic homeostasis holds good promise. Improving sleep quality can improve metabolic diseases The article emphasizes the need to strengthen the diagnosis rate of “at risk patients” and to prevent metabolic diseases through sleep quality interventions. The following lifestyle improvements can improve sleep quality: personal stress relief, ensuring a dark and quiet sleep environment, regulating bedroom temperature, regular sleep/wake cycles, light dinners without alcohol, and no video games, cell phones, or computers before bedtime. For some patients, specific interventions are necessary, such as for patients with obstructive sleep apnea syndrome, where continuous positive airway pressure ventilation can significantly improve the quality of life and health.