Polysomnography-estimated sleep and the negative feedback loop of the hypothalamic-pituitary-adrenal (HPA) axis

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Abstract

Background
Sleep and stress are highly interrelated. To improve our understanding of the role of sleep in functioning of the negative feedback loop of the stress system, we assessed the association between sleep and functioning of the hypothalamic-pituitary-adrenal (HPA) axis in a population-based sample.

Methods
This study included 403 participants (mean age: 62.4 ± 5.0 years, 55% women) of the population-based Rotterdam Study. Between 2012 and 2014, sleep was assessed with polysomnography. Functioning of the negative feedback loop of the HPA axis was estimated by measuring cortisol levels before and after the intake of a very low dose of dexamethasone (0.25 mg) on average 0.9 ± 37.8 days after the polysomnography. We used linear regression analyses adjusted for multiple confounders and performed sensitivity analyses in a sample excluding those with clinically relevant depressive symptoms and using psychoactive medicine, and a sample excluding non-suppressors.

Results
Short N2 sleep (adjusted difference = 0.005, 95%CI = 0.002;0.009), long N3 sleep (adjusted difference = −0.007, 95%CI = −0.010;−0.003), and short sleep onset latency (adjusted difference = 0.006, 95%CI = 0.001;0.011) were associated with an enhanced response to dexamethasone, but the association of sleep onset latency did not survive multiple testing correction. Associations remained similar after excluding those with clinically relevant depressive symptoms and those using psychoactive medicine or exclusion of non-suppressors.

Conclusions
This study suggests that more slow wave sleep is particularly associated with a stronger suppression of cortisol within the negative feedback loop of the HPA axis. These findings provide further support that slow wave sleep is important for health.
Original languageEnglish
Article number105749
JournalPsychoneuroendocrinology
Volume141
DOIs
Publication statusPublished - Jul 2022

Bibliographical note

Funding Information:
The Rotterdam Study is funded by Erasmus Medical Center and Erasmus University , Rotterdam, the Netherlands Organization for the Health Research and Development (ZonMw), the Research Institute for Diseases in the Elderly (RIDE), the Ministry of Education, Culture and Science , the Ministry of Health, Welfare and Sports , the European Commission (DG XII), and the Municipality of Rotterdam . This research project was made possible by an award from the Sleep Research Society Foundation awarded to AI Luik.

Publisher Copyright:
© 2022 The Authors

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