Adverse Effects of Two Nights of Sleep Restriction on the Hypothalamic-Pituitary-Adrenal Axis in Healthy Men
Adverse Effects of Two Nights of Sleep Restriction on the Hypothalamic-Pituitary-Adrenal Axis in Healthy Men
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DOI：
10.1210/jc.2013-4254
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发表时间：
2014-08-01
影响因子：
5.8
通讯作者：
Spiegel, K.
中科院分区：
文献类型：
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作者：
Guyon, A.;Balbo, M.;Spiegel, K.
背景：睡眠不足与心脏代谢风险增加有关。下丘脑-垂体-肾上腺轴的改变可能是这种联系的基础。目的：我们的目的是检查限制睡眠对白天 ACTH 和皮质醇浓度的影响。方法：13 名受试者以随机交叉设计参加 2 次实验室课程（2 晚 10 小时卧床与 2 晚 4 小时卧床）。睡眠被记录下来。每次训练的第二天晚上后，从上午 9:00 到午夜，每隔 20 分钟进行一次血液采样，以测量 ACTH 和总皮质醇。从下午 2:00 到午夜，每 20 分钟收集一次唾液，以测量游离皮质醇。通过经过验证的量表每小时评估感知的压力、饥饿和食欲。结果：睡眠限制与总 ACTH 水平增加 19% 相关 (P < .03)，这与个人睡眠不足量相关 (r(Sp) = 0.63，P < .02）。总体总皮质醇水平也升高（+21%；P = .10）。 ACTH 和皮质醇的脉冲频率没有变化。睡眠限制后早晨 ACTH 水平较高 (P < .04)，但皮质醇不伴随升高。相比之下，晚上 ACTH 水平没有变化，而总皮质醇和游离皮质醇分别增加了 30% (P < .03) 和 200% (P < .04)。因此，睡眠限制抑制了昼夜皮质醇下降的幅度（-21%；P < .05）。睡眠限制与较高的感知压力无关，但会导致食欲增加，而食欲增加与总皮质醇的增加相关。结论：睡眠不足对下丘脑-垂体-肾上腺活动的影响取决于一天中的时间。睡眠不足会抑制皮质醇的昼夜节律，皮质醇是中枢和外周生物钟的主要内部同步器。
Context: Insufficient sleep is associated with increased cardiometabolic risk. Alterations in hypothalamic-pituitary-adrenal axis may underlie this link.Objective: Our objective was to examine the impact of restricted sleep on daytime profiles of ACTH and cortisol concentrations.Methods: Thirteen subjects participated in 2 laboratory sessions (2 nights of 10 hours in bed versus 2 nights of 4 hours in bed) in a randomized crossover design. Sleep was polygraphically recorded. After the second night of each session, blood was sampled at 20-minute intervals from 9:00 AM to midnight to measure ACTH and total cortisol. Saliva was collected every 20 minutes from 2:00 PM to midnight to measure free cortisol. Perceived stress, hunger, and appetite were assessed at hourly intervals by validated scales.Results: Sleep restriction was associated with a 19% increase in overall ACTH levels (P < .03) that was correlated with the individual amount of sleep loss (r(Sp) = 0.63, P < .02). Overall total cortisol levels were also elevated (+21%; P = .10). Pulse frequency was unchanged for both ACTH and cortisol. Morning levels of ACTH were higher after sleep restriction (P < .04) without concomitant elevation of cortisol. In contrast, evening ACTH levels were unchanged while total and free cortisol increased by, respectively, 30% (P < .03) and 200% (P < .04). Thus, the amplitude of the circadian cortisol decline was dampened by sleep restriction (-21%; P < .05). Sleep restriction was not associated with higher perceived stress but resulted in an increase in appetite that was correlated with the increase in total cortisol.Conclusion: The impact of sleep loss on hypothalamic-pituitary-adrenal activity is dependent on time of day. Insufficient sleep dampens the circadian rhythm of cortisol, a major internal synchronizer of central and peripheral clocks.