Guyon Aurore, Morselli Lisa L, Balbo Marcella L, Tasali Esra, Leproult Rachel, L'Hermite-Balériaux Mireille, Van Cauter Eve, Spiegel Karine
Integrated Physiology of Brain Arousal Systems Team, Lyon Neuroscience Research Center (CRNL) - INSERM U1028, CNRS UMR5292, University Lyon 1, Lyon, France.
Pediatric Sleep Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, University Lyon 1, Lyon, France.
Sleep. 2017 Jun 1;40(6). doi: 10.1093/sleep/zsx064.
Severe sleep restriction results in elevated evening cortisol levels. We examined whether this relative hypercortisolism is associated with alterations in the pituitary-adrenocortical response to evening corticotropin-releasing hormone (CRH) stimulation.
Eleven subjects participated in 2 sessions (2 nights of 10 hours vs. 4 hours in bed) in randomized order. Sleep was polygraphically recorded. After the second night of each session, blood was sampled at 20-minute intervals from 09:00 to 24:00 for adrenocorticotropic hormone (ACTH) and cortisol measurements, and perceived stress was assessed hourly. Ovine CRH was injected at 18:00 (1 µg/kg body weight).
Prior to CRH injection, baseline ACTH, but not cortisol, levels were elevated after sleep restriction. Relative to the well-rested condition, sleep restriction resulted in a 27% decrease in overall ACTH response to CRH (estimated by the incremental area under the curve from 18:00 to 24:00; p = .002) while the cortisol response was decreased by 21% (p = .083). Further, the magnitude of these decreases was correlated with the individual amount of sleep loss (ACTH: rSp = -0.65, p = .032; cortisol: rSp = -0.71, p = .015). The acute post-CRH increment of cortisol was reduced (p = .002) without changes in ACTH reactivity, suggesting decreased adrenal sensitivity. The rate of decline from peak post-injection levels was reduced for cortisol (p = .032), but not for ACTH. Scores of perceived stress were unaffected by CRH injection and were low and similar under both sleep conditions.
Sleep restriction is associated with a reduction of the overall ACTH and cortisol responses to evening CRH stimulation, and a reduced reactivity and slower recovery of the cortisol response.
严重睡眠限制会导致夜间皮质醇水平升高。我们研究了这种相对皮质醇增多症是否与垂体 - 肾上腺皮质对夜间促肾上腺皮质激素释放激素（CRH）刺激的反应改变有关。
11名受试者按随机顺序参加2个阶段（2个晚上，一个晚上卧床10小时，另一个晚上卧床4小时）。通过多导睡眠图记录睡眠情况。在每个阶段的第二个晚上，从09:00至24:00每隔20分钟采集一次血液，用于测量促肾上腺皮质激素（ACTH）和皮质醇，并每小时评估一次感知压力。在18:00注射羊CRH（1μg/ kg体重）。
在注射CRH之前，睡眠限制后基线ACTH水平升高，但皮质醇水平未升高。相对于睡眠良好的状态，睡眠限制导致对CRH的总体ACTH反应降低27％（通过18:00至24:00曲线下增量面积估计；p = 0.002），而皮质醇反应降低21％（p = 0.083）。此外，这些降低的幅度与个体睡眠缺失量相关（ACTH：rSp = -0.65，p = 0.032；皮质醇：rSp = -0.71，p = 0.015）。CRH注射后皮质醇的急性增量减少（p = 0.002），而ACTH反应性无变化，表明肾上腺敏感性降低。注射后皮质醇从峰值水平下降的速率降低（p = 0.032），但ACTH未降低。感知压力评分不受CRH注射影响，在两种睡眠条件下均较低且相似。
睡眠限制与夜间CRH刺激后总体ACTH和皮质醇反应降低、皮质醇反应性降低以及恢复缓慢有关。
