Chronic insomnia and activity of the stress system
Abstract
The aim of this study was to assess whether there is an association between chronic insomnia and the activity of the stress system. Fifteen young adult insomniacs (<40 years) were studied. After an adaptation night, each subject was recorded in the sleep laboratory for three consecutive nights. During this period, 24-hour urine specimens were collected for measurements of urinary free cortisol (UFC), catecholamines, and growth hormone (GH). The 24-hour UFC levels were positively correlated with total wake time (p=0.05). In addition, 24-hour urinary levels of catecholamine metabolites, DHPG, and DOPAC were positively correlated with percent stage 1 sleep (p<0.05) and wake time after sleep onset (WTASO) (p<0.05). Norepinephrine tended to correlate positively with percent stage 1 sleep (p=0.063) and WTASO (p=0.074), and negatively with percent slow-wave sleep (p=0.059). Twenty-four-hour urinary GH excretion was detectable in only three insomniacs, two of whom had low indices of sleep disturbance. We conclude that, in chronic insomnia, the activity of both limbs of the stress system (i.e., the HPA axis and the sympathetic system) relates positively to the degree of objective sleep disturbance.
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Later studies found that 24-h urinary free cortisol, norepinephrine, and catecholamine metabolites levels were increased in patients with insomnia or were correlated with PSG indices of sleep disturbance in insomnia patients.
“later studies found that 24-h urinary free cortisol, norepinephrine, and catecholamine metabolites levels were increased in patients with insomnia or were correlated with PSG indices of sleep disturbance in insomnia patients(148-151).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [148]
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- Authors
- Vgontzas, A. N., Tsigos, C., Bixler, E. O., Stratakis, C. A., Zachman, K., Kales, A., Vela-Bueno, A., & Chrousos, G. P.
- Affiliations
- Pennsylvania State University (US)
- National Institutes of Health (US)
- Corresponding author
- Vgontzas, Alexandros N.
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 1998-07
- Volume
- 45
- Issue
- 1
- Pages
- 21-31
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W127750747
- Cited by
- 401
- References
- 38
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 16 · 2023: 21 · 2022: 16 · 2021: 20 · 2020: 13 · 2019: 15 · 2018: 15 · 2017: 15 · 2016: 16 · 2015: 11 · 2014: 11 · 2013: 24 · 2012: 19
- FWCI
- 6.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- chronic insomnia, stress system, hypothalamic-pituitary-adrenal axis, sympathetic nervous system, urinary free cortisol, catecholamines, norepinephrine, growth hormone, sleep disorders, wake after sleep onset, slow-wave sleep, stage 1 sleep, DOPAC, DHPG
- MeSH terms
- Adult, Catecholamines, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Sleep Initiation and Maintenance Disorders, Longitudinal Studies, Male, Pituitary-Adrenal System, Regression Analysis, Sleep, Stress, Psychological, Time Factors, Polysomnography, Human Growth Hormone
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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