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Molly L Tanenbaum Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA

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Persis V Commissariat Section on Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Boston, Massachusetts, USA

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), users have suggested that alarms can evoke strong negative emotional responses in people (e.g. anger, frustration, and panic) ( 25 ) or feelings of failure in not achieving target glucose levels ( 23 ). They can also contribute to sleep disruptions ( 15

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Sarah Byberg Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark

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Jesper Futtrup Panum Institute, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Mikkel Andreassen Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark

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Jesper Krogh Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark

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another study non-specified transient side effects occurred in 21% ( 8 ). One study reported that no participants experienced adverse events ( 7 ) and in one study 87.5% of participants experienced nausea, dizziness and sleep disturbances during treatment

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L Bahler Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

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H J Verberne Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands

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E Brakema Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

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R Tepaske Intensive Care Medicine, Academic Medical Center, Amsterdam, The Netherlands

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J Booij Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands

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J B Hoekstra Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

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F Holleman Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

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were instructed to minimize physical activity (e.g. avoid walking stairs) in the morning before the visit. Before the EE, subjects had to rest for thirty minutes on a bed. During the EE, subjects were not allowed to sleep, talk or move. The EE was

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Sylvain Roumeau CHU de Clermont-Ferrand, Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Clermont-Ferrand, France
Université Clermont Auvergne, Faculté de Médecine, Clermont-Ferrand, France

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Joannice Thevenon CHU Clermont-Ferrand, Service d’Odontologie, Clermont-Ferrand, France

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Lemlih Ouchchane Université Clermont Auvergne, CNRS, ISIT, Clermont-Ferrand, France
CHU Clermont-Ferrand, Service de Biostatistiques, Clermont-Ferrand, France

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Salwan Maqdasy Université Clermont Auvergne, Faculté de Médecine, Clermont-Ferrand, France
CHU de Clermont-Ferrand, Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Clermont-Ferrand, France
Laboratoire GReD: UMR Université Clermont Auvergne-CNRS 6293, INSERM U1103, Clermont-Ferrand, France

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Marie Batisse-Lignier CHU de Clermont-Ferrand, Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Clermont-Ferrand, France
Laboratoire GReD: UMR Université Clermont Auvergne-CNRS 6293, INSERM U1103, Clermont-Ferrand, France

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Christian Duale Université Clermont Auvergne, Inserm, Neuro-Dol, Clermont-Ferrand, France
CHU Clermont-Ferrand, Inserm CIC 1405, Clermont-Ferrand, France

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Nathalie Pham Dang Université Clermont Auvergne, Faculté de Médecine, Clermont-Ferrand, France
Université Clermont Auvergne, Inserm, Neuro-Dol, Clermont-Ferrand, France
CHU de Clermont-Ferrand, Service de chirurgie maxillo-faciale, Clermont-Ferrand, France

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Philippe Caron CHU Larrey-Rangueil, Service Endocrinologie et Maladies Métaboliques, Pôle Cardio-Vasculaire et Métabolique, Toulouse, France

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Igor Tauveron CHU de Clermont-Ferrand, Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Clermont-Ferrand, France
Université Clermont Auvergne, Faculté de Médecine, Clermont-Ferrand, France
Laboratoire GReD: UMR Université Clermont Auvergne-CNRS 6293, INSERM U1103, Clermont-Ferrand, France

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Laurent Devoize CHU Clermont-Ferrand, Service d’Odontologie, Clermont-Ferrand, France
Université Clermont Auvergne, Inserm, Neuro-Dol, Clermont-Ferrand, France
Université Clermont Auvergne, Faculté de Chirurgie Dentaire, Clermont-Ferrand, France

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obstructive sleep apnea ( 1 , 2 , 3 , 4 , 5 , 6 ). They can develop precociously as oral symptoms were reported to be the first symptoms of the disease by 10% of the patients and to be present at diagnosis for more than 20% of them ( 7 ). However, many

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Eva Jakobsson Ung Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

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Ann-Charlotte Olofsson Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

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Ida Björkman Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden

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Tobias Hallén Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden

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Daniel S Olsson Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Oskar Ragnarsson Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Thomas Skoglund Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden

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Sofie Jakobsson Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden

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Gudmundur Johannsson Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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, motivation and capacity. One man described ‘Yes, I was very tired all the time … could sleep several hours and far into the day. I did not know what was wrong … but I … my parents thought I was lazy. I thought that maybe I am…’ . Other patients went

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Carlo Cinque Fondazione Ethoikos, Radicondoli, Italy
Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Rome, Italy

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Manuela Zinni Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Rome, Italy

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Anna Rita Zuena Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Rome, Italy

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Chiara Giuli Fondazione Ethoikos, Radicondoli, Italy

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Sebastiano G Alemà Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Rome, Italy

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Assia Catalani Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Rome, Italy

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Paola Casolini Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Rome, Italy

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Roberto Cozzolino Fondazione Ethoikos, Radicondoli, Italy

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(EE) ( 14 ). They choose to share a common sleeping site and usually sleep close together regardless of social status ( 15 ). For these reasons, solitary housing can be considered a stressor in social species ( 16 ), and it can deeply modify the

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Shane M Regnier Committee on Molecular Metabolism and Nutrition, Chicago, Illinois, USA
Pritzker School of Medicine, Chicago, Illinois, USA
University of Chicago, Chicago, Illinois, USA

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Andrew G Kirkley University of Chicago, Chicago, Illinois, USA
Committee on Molecular Pathogenesis and Molecular Medicine, Chicago, Illinois, USA

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Daniel Ruiz Committee on Molecular Metabolism and Nutrition, Chicago, Illinois, USA
University of Chicago, Chicago, Illinois, USA

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Wakanene Kamau University of Chicago, Chicago, Illinois, USA

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Qian Wu Wadsworth Center, New York Department of Health, Albany, New York, USA

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Kurunthachalam Kannan Wadsworth Center, New York Department of Health, Albany, New York, USA

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Robert M Sargis Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA

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approximately 50% projected to be obese by 2030 ( 2 ). Obesity is a major risk factor for the development of cardiovascular disease, obstructive sleep apnea and nonalcoholic fatty liver disease ( 3 , 4 ), and the societal expansion in fat mass is thought to

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Alessandro Barbato Auxo-endocrinology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
Department of Health Sciences, University of Florence, Florence, Italy

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Giulia Gori Medical Genetics Unit, Meyer Children’s Hospital IRCCS, Florence, Italy

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Michele Sacchini Metabolic and Muscular Unit, Meyer Children's Hospital IRCCS, Florence, Italy

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Francesca Pochiero Metabolic and Muscular Unit, Meyer Children's Hospital IRCCS, Florence, Italy

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Sara Bargiacchi Medical Genetics Unit, Meyer Children’s Hospital IRCCS, Florence, Italy

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Giovanna Traficante Medical Genetics Unit, Meyer Children’s Hospital IRCCS, Florence, Italy

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Viviana Palazzo Medical Genetics Unit, Meyer Children’s Hospital IRCCS, Florence, Italy

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Lucia Tiberi Medical Genetics Unit, Meyer Children’s Hospital IRCCS, Florence, Italy

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Claudia Bianchini Pediatric Neurology and Neurogenetics Unit and Laboratories, Meyer Children’s Hospital IRCCS, Florence, Italy

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Davide Mei Pediatric Neurology and Neurogenetics Unit and Laboratories, Meyer Children’s Hospital IRCCS, Florence, Italy

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Elena Parrini Pediatric Neurology and Neurogenetics Unit and Laboratories, Meyer Children’s Hospital IRCCS, Florence, Italy

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Tiziana Pisano Pediatric Neurology and Neurogenetics Unit and Laboratories, Meyer Children’s Hospital IRCCS, Florence, Italy

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Elena Procopio Metabolic and Muscular Unit, Meyer Children's Hospital IRCCS, Florence, Italy

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Renzo Guerrini Pediatric Neurology and Neurogenetics Unit and Laboratories, Meyer Children’s Hospital IRCCS, Florence, Italy
NEUROFARBA Department, University of Florence, Florence, Italy

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Angela Peron Medical Genetics Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
Department of Clinical and Experimental Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy

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Stefano Stagi Auxo-endocrinology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
Department of Health Sciences, University of Florence, Florence, Italy

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-epilectic medications Brain MRI Hepatic US Patient 1 (M) −5.34 0.57 −4.90 1.41 GHD, CH, AI, CHG Generalized clonic 2 years FT high amplitude spike and slow wave complexes(sleep) Valproate acid, levetiracetam, topiramate, clobazam

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Filippo Ceccato Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Elisa Selmin Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Chiara Sabbadin Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Miriam Dalla Costa Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Giorgia Antonelli Laboratory Medicine, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Mario Plebani Laboratory Medicine, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Mattia Barbot Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Corrado Betterle Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Marco Boscaro Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Carla Scaroni Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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(F 1.5h ), 6 h (F 6h , before lunch), 8 h and 30 min (F 8.5h ) and 12 h (F 12h , before dinner) after the first one, F b was gathered before sleeping ( 14 ). F a and F 6h samples were collected immediately before taking the morning and afternoon

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Yusaku Mori Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan

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Hiroyuki Shimizu Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan
Maebashi Hirosegawa Clinic, Maebashi, Gunma, Japan

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Hideki Kushima Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan

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Tomomi Saito Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan

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Munenori Hiromura Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan

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Michishige Terasaki Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan

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Masakazu Koshibu Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan

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Hirokazu Ohtaki Department of Anatomy, Showa University School of Medicine, Shinagawa, Tokyo, Japan

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Tsutomu Hirano Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, Shinagawa, Tokyo, Japan

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nesfatin-1 in patients with obstructive sleep apnea syndrome . Sleep and Breathing 2015 19 515 – 522 . ( https://doi.org/10.1007/s11325-014-1039-0 ) 10.1007/s11325-014-1039-0 8 Zhai T Li SZ Fan XT Tian Z Lu XQ Dong J . Circulating nesfatin-1

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