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Epidemiological studies consistently show an association between insufficient sleep and metabolic dysfunction. Mechanistically, sleep and circadian rhythm exert considerable influences on hormones involved in appetite regulation and energy metabolism. As such, data from experimental sleep deprivation in humans demonstrate that insufficient sleep induces a positive energy balance with resultant weight gain, due to increased energy intake that far exceeds the additional energy expenditure of nocturnal wakefulness, and adversely impacts glucose metabolism. Conversely, animal models have found that sleep loss\u2013induced energy expenditure exceeds caloric intake resulting in net weight loss. However, animal models have significant limitations, which may diminish the clinical relevance of their metabolic findings. Clinically, insomnia disorder and insomnia symptoms are associated with adverse glucose outcomes, though it remains challenging to isolate the effects of insomnia on metabolic outcomes independent of comorbidities and insufficient sleep durations. Furthermore, both pharmacological and behavioral interventions for insomnia may have direct metabolic effects. The goal of this review is to establish an updated framework for the causal links between insufficient sleep and insomnia and risks for type 2 diabetes and obesity.<\/jats:p>","DOI":"10.1111\/nyas.14926","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T02:44:27Z","timestamp":1668393867000},"page":"94-117","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":110,"title":["Connecting insufficient sleep and insomnia with metabolic dysfunction"],"prefix":"10.1111","volume":"1519","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4392-3206","authenticated-orcid":false,"given":"Daisy","family":"Duan","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenise J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan C.","family":"Jun","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2951-7535","authenticated-orcid":false,"given":"Vsevolod Y.","family":"Polotsky","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0706446105"},{"key":"e_1_2_11_3_1","first-page":"195","article-title":"A two process model of sleep regulation","volume":"1","author":"Borbely A. 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