Vgontzas A N, Bixler E O, Wittman A M, Zachman K, Lin H M, Vela-Bueno A, Kales A, Chrousos G P
Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University, Hershey, Pennsylvania 17033, USA.
J Clin Endocrinol Metab. 2001 Apr;86(4):1489-95. doi: 10.1210/jcem.86.4.7370.
The prevalence of insomnia associated with emotional stress increases markedly in middle-age. Both the top and end hormones of the hypothalamic-pituitary-adrenal axis, i.e. CRH and glucocorticoids, stimulate arousal/wakefulness and inhibit slow wave (deep) sleep in experimental animals and man. The objective of this study was to test the hypothesis that middle-age is characterized by increased sensitivity to the sleep-disturbing effects of the hypothalamic-pituitary-adrenal axis. We studied 12 healthy middle-aged (45.1 +/- 4.9) and 12 healthy young (22.7 +/- 2.8) men by monitoring their sleep by polysomnography for 4 consecutive nights, including in tandem 1 adaptation and 2 baseline nights and a night during which we administered equipotent doses of ovine CRH (1 microg/kg, iv bolus) 10 min after sleep onset. Analyses included comparisons within and between groups using multiple ANOVA and regression analysis. Although both middle-aged and young men responded to CRH with similar elevations of ACTH and cortisol, the former had significantly more wakefulness and suppression of slow wave sleep compared with baseline sleep; in contrast, the latter showed no change. Also, comparison of the change in sleep patterns from baseline to the CRH night in the young men to the respective change observed in middle-aged men showed that middle-age was associated with significantly higher wakefulness and significantly greater decrease in slow wave sleep than in young age. We conclude that middle-aged men show increased vulnerability of sleep to stress hormones, possibly resulting in impairments in the quality of sleep during periods of stress. We suggest that changes in sleep physiology associated with middle-age play a significant role in the marked increase of prevalence of insomnia in middle-age.
与情绪压力相关的失眠患病率在中年时显著增加。下丘脑 - 垂体 - 肾上腺轴的顶端和终端激素，即促肾上腺皮质激素释放激素（CRH）和糖皮质激素，在实验动物和人类中均刺激觉醒/清醒并抑制慢波（深度）睡眠。本研究的目的是检验以下假设：中年的特征是对下丘脑 - 垂体 - 肾上腺轴睡眠干扰作用的敏感性增加。我们通过多导睡眠图连续4晚监测了12名健康中年男性（45.1±4.9岁）和12名健康青年男性（22.7±2.8岁）的睡眠情况，包括1个适应夜和2个基线夜，以及在睡眠开始后10分钟静脉推注等剂量羊CRH（1微克/千克）的一晚。分析包括使用多因素方差分析和回归分析在组内和组间进行比较。尽管中年和青年男性对CRH的反应均表现为促肾上腺皮质激素（ACTH）和皮质醇的相似升高，但与基线睡眠相比，前者的清醒时间显著增加，慢波睡眠受到抑制；相比之下，后者没有变化。此外，将青年男性从基线到CRH夜睡眠模式的变化与中年男性观察到的相应变化进行比较，结果显示中年与青年相比，清醒时间显著增加，慢波睡眠减少幅度显著更大。我们得出结论，中年男性睡眠对应激激素的易感性增加，这可能导致应激期间睡眠质量受损。我们认为，与中年相关的睡眠生理变化在中年失眠患病率的显著增加中起重要作用。
