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Impact of sleep and its disturbances on hypothalamo-pituitary-adrenal axis activity.

Balbo M, Leproult R, Van Cauter E - Int J Endocrinol (2010)

Bottom Line: Sleep has modest but clearly detectable modulatory effects on HPA axis activity.During waking, an association between cortisol secretory bursts and indices of central arousal has also been detected.Abrupt shifts of the sleep period induce a profound disruption in the daily cortisol rhythm, while sleep deprivation and/or reduced sleep quality seem to result in a modest but functionally important activation of the axis.

View Article: PubMed Central - PubMed

Affiliation: Sleep, Chronobiology and Neuroendocrinology Research Laboratory, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA.

ABSTRACT
The daily rhythm of cortisol secretion is relatively stable and primarily under the influence of the circadian clock. Nevertheless, several other factors affect hypothalamo-pituitary-adrenal (HPA) axis activity. Sleep has modest but clearly detectable modulatory effects on HPA axis activity. Sleep onset exerts an inhibitory effect on cortisol secretion while awakenings and sleep offset are accompanied by cortisol stimulation. During waking, an association between cortisol secretory bursts and indices of central arousal has also been detected. Abrupt shifts of the sleep period induce a profound disruption in the daily cortisol rhythm, while sleep deprivation and/or reduced sleep quality seem to result in a modest but functionally important activation of the axis. HPA hyperactivity is clearly associated with metabolic, cognitive and psychiatric disorders and could be involved in the well-documented associations between sleep disturbances and the risk of obesity, diabetes and cognitive dysfunction. Several clinical syndromes, such as insomnia, depression, Cushing's syndrome, sleep disordered breathing (SDB) display HPA hyperactivity, disturbed sleep, psychiatric and metabolic impairments. Further research to delineate the functional links between sleep and HPA axis activity is needed to fully understand the pathophysiology of these syndromes and to develop adequate strategies of prevention and treatment.

No MeSH data available.


Related in: MedlinePlus

Cortisol rhythm under different sleep conditions.  (a) and (b): 24-hour (+ SEM) cortisol profiles under 4 hours (a) and 12 hours (b) bedtimes (Adapted from Spiegel et al. [84]). (c) and (d): 24-hour (+ SEM) cortisol profiles in young insomniacs (c) and age, and BMI-matched controls (d) (Adapted from Vgontzas et al. [105]). Black bars represent the sleep periods.
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fig6: Cortisol rhythm under different sleep conditions. (a) and (b): 24-hour (+ SEM) cortisol profiles under 4 hours (a) and 12 hours (b) bedtimes (Adapted from Spiegel et al. [84]). (c) and (d): 24-hour (+ SEM) cortisol profiles in young insomniacs (c) and age, and BMI-matched controls (d) (Adapted from Vgontzas et al. [105]). Black bars represent the sleep periods.

Mentions: An early study failed to show any difference in urinary cortisol excretion between control and self-reported poor sleepers [103]. However, the EEG recorded difference between the two groups was only half an hour in total sleep time: such a small difference may have prevented the detection of alteration in cortisol secretion. On the contrary, in a more recent experiment, 24-hour urinary free cortisol excretion was positively correlated with polysomnographic indices of sleep disturbance in a group of adult insomniacs [104]. Moreover, a study that collected 24-hour plasma ACTH and cortisol profiles in young insomniacs and in matched healthy controls found mean ACTH and cortisol levels higher in insomniacs than in controls, with the stronger elevations observed in the afternoon, in the late evening and in the early part of the night [105] (Figure 6). In addition, within the insomniacs, those with a high degree of sleep disturbance, compared with those with a low degree of sleep disturbance, secreted a higher amount of cortisol, particularly in the evening and in the nighttime periods.


Impact of sleep and its disturbances on hypothalamo-pituitary-adrenal axis activity.

Balbo M, Leproult R, Van Cauter E - Int J Endocrinol (2010)

Cortisol rhythm under different sleep conditions.  (a) and (b): 24-hour (+ SEM) cortisol profiles under 4 hours (a) and 12 hours (b) bedtimes (Adapted from Spiegel et al. [84]). (c) and (d): 24-hour (+ SEM) cortisol profiles in young insomniacs (c) and age, and BMI-matched controls (d) (Adapted from Vgontzas et al. [105]). Black bars represent the sleep periods.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2902103&req=5

fig6: Cortisol rhythm under different sleep conditions. (a) and (b): 24-hour (+ SEM) cortisol profiles under 4 hours (a) and 12 hours (b) bedtimes (Adapted from Spiegel et al. [84]). (c) and (d): 24-hour (+ SEM) cortisol profiles in young insomniacs (c) and age, and BMI-matched controls (d) (Adapted from Vgontzas et al. [105]). Black bars represent the sleep periods.
Mentions: An early study failed to show any difference in urinary cortisol excretion between control and self-reported poor sleepers [103]. However, the EEG recorded difference between the two groups was only half an hour in total sleep time: such a small difference may have prevented the detection of alteration in cortisol secretion. On the contrary, in a more recent experiment, 24-hour urinary free cortisol excretion was positively correlated with polysomnographic indices of sleep disturbance in a group of adult insomniacs [104]. Moreover, a study that collected 24-hour plasma ACTH and cortisol profiles in young insomniacs and in matched healthy controls found mean ACTH and cortisol levels higher in insomniacs than in controls, with the stronger elevations observed in the afternoon, in the late evening and in the early part of the night [105] (Figure 6). In addition, within the insomniacs, those with a high degree of sleep disturbance, compared with those with a low degree of sleep disturbance, secreted a higher amount of cortisol, particularly in the evening and in the nighttime periods.

Bottom Line: Sleep has modest but clearly detectable modulatory effects on HPA axis activity.During waking, an association between cortisol secretory bursts and indices of central arousal has also been detected.Abrupt shifts of the sleep period induce a profound disruption in the daily cortisol rhythm, while sleep deprivation and/or reduced sleep quality seem to result in a modest but functionally important activation of the axis.

View Article: PubMed Central - PubMed

Affiliation: Sleep, Chronobiology and Neuroendocrinology Research Laboratory, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA.

ABSTRACT
The daily rhythm of cortisol secretion is relatively stable and primarily under the influence of the circadian clock. Nevertheless, several other factors affect hypothalamo-pituitary-adrenal (HPA) axis activity. Sleep has modest but clearly detectable modulatory effects on HPA axis activity. Sleep onset exerts an inhibitory effect on cortisol secretion while awakenings and sleep offset are accompanied by cortisol stimulation. During waking, an association between cortisol secretory bursts and indices of central arousal has also been detected. Abrupt shifts of the sleep period induce a profound disruption in the daily cortisol rhythm, while sleep deprivation and/or reduced sleep quality seem to result in a modest but functionally important activation of the axis. HPA hyperactivity is clearly associated with metabolic, cognitive and psychiatric disorders and could be involved in the well-documented associations between sleep disturbances and the risk of obesity, diabetes and cognitive dysfunction. Several clinical syndromes, such as insomnia, depression, Cushing's syndrome, sleep disordered breathing (SDB) display HPA hyperactivity, disturbed sleep, psychiatric and metabolic impairments. Further research to delineate the functional links between sleep and HPA axis activity is needed to fully understand the pathophysiology of these syndromes and to develop adequate strategies of prevention and treatment.

No MeSH data available.


Related in: MedlinePlus