The Role of Sex in the Impact of Sleep Restriction on Appetite- and Weight-Regulating Hormones in Healthy Adults: A Systematic Review of Human Studies.
Level 1 - systematic review of randomized trials
Systematic review of experimental human trials (evaluated with Cochrane RoB 2)
PubMed 40843663 · doi:10.3390/clockssleep7030039
What was done
A systematic review was conducted across PubMed, Embase, Cochrane, CINAHL, and PsycINFO through December 2024 to determine whether sex modifies the response of appetite- and weight-regulating hormones to sleep restriction. Eligible experimental studies evaluated healthy adults, measured at least one appetite-related hormone, and reported sex-specific analyses. Studies involving medical conditions affecting sleep, circadian misalignment, or co-interventions were excluded. Risk of bias was appraised with the Cochrane RoB 2 tool, and findings were synthesized narratively by hormone.
What was found
Eight studies with 302 total participants met inclusion criteria. Sex-related variations in response to sleep restriction were reported inconsistently across individual hormones: leptin (4 studies, n = 232), ghrelin (3 studies, n = 87), insulin (3 studies, n = 56), adiponectin (2 studies, n = 71), thyroxine (2 studies, n = 41), and glucagon-like peptide-1 (1 study, n = 27). No clear directional patterns emerged across these studies. No sex-related differences were detected for glucagon or peptide YY (PYY), though data were limited.
Why it matters
While sex differences are frequently proposed to explain conflicting evidence on sleep loss and metabolic dysregulation, current human experimental data remain too limited and heterogeneous to support definitive conclusions.
Limits
The total evidence base is small (8 studies, 302 total subjects), with most individual hormone analyses based on fewer than 100 participants. The abstract notes inconsistent findings with no clear patterns and does not provide quantitative pooled effect estimates, while key modifiers such as baseline BMI and energy balance were inadequately accounted for.