Sleep and circadian effects on the incretin system.

PURPOSE OF REVIEW: Little is known about how incretins interact with sleep and circadian factors, both of which influence metabolic outcomes. We review evidence that sleep, circadian rhythms, and their disturbances impact incretin secretion and discuss clinical applications for GLP-1/GIP-RA drugs in sleep medicine and areas for future research. RECENT FINDINGS: GLP-1 secretion exhibits a circadian rhythm which may be disrupted by high-fat diet, meal timing, and gut dysbiosis. Insufficient sleep may alter the timing of postprandial GLP-1 release, and the circadian rhythm of GLP-1 secretion is blunted in patients with metabolic conditions such as obesity or diabetes. Lastly, the FDA has approved the use of tirzepatide (a GLP-1/GIP-RA drug) for treating obstructive sleep apnea. SUMMARY: Evidence suggests that sleep and circadian rhythms impact the incretin system, although findings are somewhat mixed due to the variety of methods employed. In light of the growing interest in new clinical applications for incretin therapies, more research is needed to fully understand the relationship between sleep, circadian rhythms, and incretin secretion.