The DOI matches its Crossref record; 150 of the 155 references it cites were found in a registry or an index; none of the 116 sources its claims cite is checked for support yet.
Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity
Open accessAbstract
The daily rhythm of cortisol secretion is relatively stable and primarily under the influence of the circadian clock. Nevertheless, several other factors affect hypothalamo-pituitary-adrenal (HPA) axis activity. Sleep has modest but clearly detectable modulatory effects on HPA axis activity. Sleep onset exerts an inhibitory effect on cortisol secretion while awakenings and sleep offset are accompanied by cortisol stimulation. During waking, an association between cortisol secretory bursts and indices of central arousal has also been detected. Abrupt shifts of the sleep period induce a profound disruption in the daily cortisol rhythm, while sleep deprivation and/or reduced sleep quality seem to result in a modest but functionally important activation of the axis. HPA hyperactivity is clearly associated with metabolic, cognitive and psychiatric disorders and could be involved in the well-documented associations between sleep disturbances and the risk of obesity, diabetes and cognitive dysfunction. Several clinical syndromes, such as insomnia, depression, Cushing's syndrome, sleep disordered breathing (SDB) display HPA hyperactivity, disturbed sleep, psychiatric and metabolic impairments. Further research to delineate the functional links between sleep and HPA axis activity is needed to fully understand the pathophysiology of these syndromes and to develop adequate strategies of prevention and treatment.
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Written from the paper’s full text.
TL;DR
This review summarizes evidence that sleep has modest but detectable modulatory effects on hypothalamo-pituitary-adrenal (HPA) axis activity, with sleep onset inhibiting cortisol and awakenings stimulating it. It argues that sleep loss, shifted sleep, and sleep disruption can activate the HPA axis and that HPA hyperactivity is linked with insomnia, depression, Cushing's syndrome, and sleep disordered breathing.
Key findings
- Sleep onset exerts a modest inhibitory effect on cortisol lasting 1–2 hours, while nocturnal awakenings transiently elevate cortisol and final morning awakening produces a rapid rise persisting about one hour.
- Abrupt 8-hour sleep-wake delays profoundly disrupt the 24-hour cortisol rhythm: on the first shifted day, the quiescent period was reduced by more than 3 hours, relative amplitude fell by approximately 40%, and the acrophase was delayed by about 3 hours 30 minutes; by day 5 the profile had essentially adapted.
- An 8-hour advance shifted the nadir by about 3 hours 20 minutes and reduced the quiescent period mainly via an advance of its offset by more than 3 hours, with the rising phase lengthened by nearly 3 hours and no shift in acrophase.
- Partial sleep restriction elevated evening cortisol: after 6 nights of 4 hours in bed in 11 young men, the quiescent period onset was delayed by nearly 1.5 hours and salivary free cortisol decline from 16:00 to 21:00 was about six times slower than when fully rested; after only 1 night of 4 hours in bed, plasma cortisol over 18:00–23:00 was 37% higher and quiescent onset occurred 1 hour later.
Methods
- Narrative review of human and animal studies on sleep, sleep disturbances, and HPA axis activity, including experimental protocols such as constant routine, shifted sleep, ultradian schedules, total sleep deprivation, partial sleep restriction, sleep-stage suppression, and sleep fragmentation.
- Synthesizes findings from clinical syndromes including insomnia, major depression, Cushing's syndrome, and sleep disordered breathing/obstructive sleep apnea, with cited sample sizes and outcomes where reported.
- No primary data collection or new statistical analysis is reported; the paper is a qualitative synthesis of the literature.
Limitations
- The paper states that further research is needed to delineate functional links between sleep and HPA axis activity and to understand the pathophysiology of associated syndromes.
- It explicitly notes contradictory findings and methodological limitations in sleep-deprivation and SDB studies, including small sample sizes, variable sleep-recording hours, variable SDB severity, single-time-point cortisol measures, and variable CPAP compliance.
- Evident from the text: as a narrative review, it does not describe a systematic search strategy, formal quality assessment, or quantitative meta-analysis.
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In the paper
“In addition, the rate of decrease of free cortisol concentrations in saliva between 16.00 hours and 21.00 hours was about six times slower in the sleep-debt than in the fully rested condition.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.2. Semichronic Partial Sleep Restriction
What the sources say
- Not checked yetcites [83] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Indeed, some authors have reported no change [41, 43, 74, 75] or even a slight decrease in cortisol levels [76, 77] after one or several nights of total sleep deprivation.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.1. Acute Total Sleep Loss
What the sources say
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“while in some studies cortisol secretion seemed to be almost unaffected by recovery sleep following prolonged wakefulness [78–80]”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.1. Acute Total Sleep Loss
What the sources say
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Interestingly, cortisol evening levels observed under 8-hour bedtime condition were intermediate between those measured under 4-hour and 12-hour bedtime conditions [84] (Figure 5).”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.2. Semichronic Partial Sleep Restriction
What the sources say
- Not checked yetcites [84] source
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“No significant changes in cortisol profiles were found.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.3. Impact of Disrupted Sleep Quality
What the sources say
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In this protocol, however, there was a temporal coincidence between the phase markers and the sleep-wake and dark-light transition (at 23:00), which elicited robust cortisol pulses.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 4. Effects of Shifted Sleep on Hpa Axis > 4.2. Advance of the Sleep-Wake Cycle
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the findings of this study showed that an abrupt 8-hour advance of the sleep-wake, rest-activity and dark-light cycle results in a 3- to 4-hour advance of the timing of the nadir and of the end of the quiescent period, which are both reliable markers of central circadian rhythmicity.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 4. Effects of Shifted Sleep on Hpa Axis > 4.2. Advance of the Sleep-Wake Cycle
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“In this regard, it is notable that chronic short sleepers have been found to have higher nocturnal cortisol levels compared with chronic long sleepers [40]”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.2. Semichronic Partial Sleep Restriction
What the sources say
- Not checked yetcites [40] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Decreased cortisol levels have been reported in a study of REM suppression [92].”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.3. Impact of Disrupted Sleep Quality
What the sources say
- Not checked yetcites [92] 1988, Biological Psychiatry source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Notably, the decrease in plasma or urinary cortisol found by Kant et al. [77] and Åkerstedt et al. [76] occurred after 48 hours or more of prolonged wakefulness.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.1. Acute Total Sleep Loss
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- It may state two separate claims as one. 32
- Probably not a substantial claim. 8
In the paper
“The state of sleep debt, as compared to the fully rested state, was associated with elevated cortisol concentrations in the afternoon and in the early evening and with a shorter quiescent period, due to a delay in its onset by nearly 1.5 hour.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.2. Semichronic Partial Sleep Restriction
What the sources say
- Not checked yetcites [83] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Following 2 nights of experimental sleep fragmentation across all stages, an increase in morning cortisol levels was observed, in association with a shift in the sympatho-vagal balance, estimated from the analysis of the heart rate variability towards an increase of sympathetic nervous system activity, and a decrease in insulin sensitivity.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.3. Impact of Disrupted Sleep Quality
What the sources say
- Not checked yetcites [93] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Several studies have reported an elevation of cortisol levels both during the night of total sleep deprivation [13, 35, 72] and, if wakefulness was further prolonged, during the following day, particularly in the afternoon and evening [63, 73].”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.1. Acute Total Sleep Loss
What the sources say
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Short sleep duration was associated with an acute increased cortisol awakening response and both short sleep duration and disturbances were independently associated with a slower rate of decline of cortisol levels across the day and thus with increased evening levels.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.2. Semichronic Partial Sleep Restriction
What the sources say
- Not checked yetcites [85] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Therefore, despite a relatively fast adaptation of some circadian markers, the lack of adaptation of acrophase, the longer duration of the rising phase, and the shorter duration of the quiescent period resulted in elevated cortisol levels at the time of the usual trough of the profile.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 4. Effects of Shifted Sleep on Hpa Axis > 4.2. Advance of the Sleep-Wake Cycle
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Vgontzas et al. [81] found a significant decrease in plasma cortisol levels, that appeared to be negatively correlated with the rebound increase of SWS.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.1. Acute Total Sleep Loss
What the sources say
- Not checked yetcites [81] source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“In this study, plasma cortisol levels over the 1800–2300 hour period were 37% higher on the day following the night of restricted sleep than on the previous day, and the onset of the quiescent period occurred 1 hour later.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.2. Semichronic Partial Sleep Restriction
What the sources say
- Not checked yetcites [73] 1997, Sleep
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“An important interplay is also the excitatory reciprocal interaction between the HPA axis and the brainstem sympathetic locus coeruleus (LC)-norepinephrine (NE) system: CRH activates the LC; in turn, NE, a known wake-promoting neurotransmitter, activates hypothalamic CRH [9, 10].”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 2. Physiology of Hypothalamo-Pituitary-Adrenal (HPA) Axis
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Circadian rhythms are generated by the endogenous master pacemaker located in the paired suprachiasmatic nucleus (SCN) of the hypothalamus and are kept entrained to the local conditions by environmental timing cues; the most important of these cues is light, that signaled to the SCN by direct input from the retina via the retinohypothalamic tract [1].”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 1. Introduction
What the sources say
- Not checked yetcites [1] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The daylong cortisol decline may represent the rate of recovery of the axis from this endogenous challenge.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 2. Physiology of Hypothalamo-Pituitary-Adrenal (HPA) Axis
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“awakenings and sleep offset are accompanied by cortisol stimulation”
- Also stated in: § 3.1. Impact of Sleep Onset and Offset · boosted
“An influence of sleep-wake transitions on cortisol secretion is also detectable during nocturnal awakenings which are consistently associated with a transient elevation of cortisol levels, followed by temporary inhibition of cortisol secretion [38].”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § 3.1. Impact of Sleep Onset and Offset · boosted
None of the sources cited for this claim have been checked yet.
In the paper
“circadian oscillators have been found in a number of peripheral tissues, such as liver, heart, lung, skeletal muscle, and adrenal glands [2, 3].”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 1. Introduction
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In addition, the HPA axis receives relevant feedback from other areas of the brain, such as the hippocampus and amygdala [8].”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 2. Physiology of Hypothalamo-Pituitary-Adrenal (HPA) Axis
What the sources say
- Not checked yetcites [8] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Thus, the late night rise in cortisol appears to dampen amygdala-dependent emotional processing and could exert a protective function by preventing excessive emotionality in memory.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 3. Effects of Normal Sleep on HPA Axis > 3.2. Modulatory Effects of Sleep Stages
What the sources say
- Not checked yetcites [58] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Both a higher nadir value, due to the lack of the inhibitory effect of sleep onset, and a lower acrophase value, due to the lack of the stimulatory effect of awakening, were observed.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 4. Effects of Shifted Sleep on Hpa Axis > 4.1. Delay of the Sleep-Wake Cycle
What the sources say
- Not checked yetcites [67] 2000, Sleep
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“ApEn analysis revealed that greater age is associated with more irregular patterns of cortisol, but not ACTH secretion”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 2. Physiology of Hypothalamo-Pituitary-Adrenal (HPA) Axis
What the sources say
- Not checked yetcites [33] 1998, European Journal of Endocrinology source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“On the third day, as a sign of partial adaptation to the new schedule, the circadian onset of cortisol was delayed by more than 5 hours, while the timing of the acrophase was delayed by more than 6 hours.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 4. Effects of Shifted Sleep on Hpa Axis > 4.1. Delay of the Sleep-Wake Cycle
What the sources say
- Not checked yetcites [67] 2000, Sleep
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In the cortisol profile, the end of the quiescent period and the onset of the daily rise are mostly under the control of circadian rhythmicity, while the timing of the acrophase and the amplitude of the diurnal variation are more influenced by sleep-wake transitions.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 4. Effects of Shifted Sleep on Hpa Axis
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“In this study, mean ACTH concentrations, basal and pulsatile ACTH secretion directly correlated with BMI and were higher in men than in women, after controlling of BMI.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 2. Physiology of Hypothalamo-Pituitary-Adrenal (HPA) Axis
What the sources say
- Not checked yetcites [32] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“In addition, in men, ACTH-cortisol feedforward synchrony and cortisol-ACTH feedback synchrony both decline with age, as quantified by cross-ApEn, denoting a deterioration of coordinate control of ACTH and cortisol secretion patterns.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 2. Physiology of Hypothalamo-Pituitary-Adrenal (HPA) Axis
What the sources say
- Not checked yetcites [32] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Given that high-frequency EEG over 20 Hz is considered a marker of daytime arousal [64], a functional link between the regulatory mechanisms controlling the HPA activity and the level of central arousal has been hypothesized.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 3. Effects of Normal Sleep on HPA Axis > 3.2. Modulatory Effects of Sleep Stages
What the sources say
- Not checked yetcites [64] 2000, NeuroReport source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✗ Asserted: fails✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it.
In the paper
“In young adulthood, women appeared to have, compared to men, lower 24-hour mean cortisol levels, a longer quiescent period (that started earlier and ended later), a lower acrophase, and a lower absolute amplitude of the circadian variation.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 2. Physiology of Hypothalamo-Pituitary-Adrenal (HPA) Axis
What the sources say
- Not checked yetcites [31] source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“In addition, the timing of the nadir and of the onset of the nocturnal cortisol rise are advanced in older adults of both sexes and the circadian amplitude, when expressed as a percentage of the 24-hour mean level, is decreased”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 2. Physiology of Hypothalamo-Pituitary-Adrenal (HPA) Axis
What the sources say
- Not checked yetcites [31] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“During the second postshift period (day 3), minor signs of further adaptation of the cortisol profiles were detected: there was no further advance of the timing of the nadir and only a minor additional advance of the onset of the quiescent period.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 4. Effects of Shifted Sleep on Hpa Axis > 4.2. Advance of the Sleep-Wake Cycle
What the sources say
- Not checked yetcites [68] 2002, American Journal of Physiology source
Strength:plain· not yet calibratedn = 8Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Metyrapone suppressed cortisol concentrations, especially the rise in cortisol during late sleep, and decreased time spent in SWS, which was replaced by shallow NREM sleep. REM sleep was preserved.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 3. Effects of Normal Sleep on HPA Axis > 3.2. Modulatory Effects of Sleep Stages
What the sources say
- Not checked yetcites [58] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“While memory for the neutral texts was reduced, interestingly metyrapone even amplified emotional enhancement in text recall”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 3. Effects of Normal Sleep on HPA Axis > 3.2. Modulatory Effects of Sleep Stages
What the sources say
- Not checked yetcites [58] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“On the first day after the shift, profound disruptions in the 24-hour cortisol rhythm were found: a reduction of more than 3 hours in the duration of the quiescent period resulted in an increase of the 24-hour mean levels and in the advance of the circadian onset.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 4. Effects of Shifted Sleep on Hpa Axis > 4.1. Delay of the Sleep-Wake Cycle
What the sources say
- Not checked yetcites [67] 2000, Sleep
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“In the first postshift period, compared with the baseline profile, the timing of the nadir was advanced by about 3 hours and 20 minutes; the quiescent period was markedly reduced mainly due to an advance of the offset by more than 3 hours.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 4. Effects of Shifted Sleep on Hpa Axis > 4.2. Advance of the Sleep-Wake Cycle
What the sources say
- Not checked yetcites [68] 2002, American Journal of Physiology source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“In the same study, aging was associated, in both sexes, with a progressive increase of 24-hour mean levels from the 2nd to the 8th decade, associated with a shorter quiescent period and higher nadir values.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 2. Physiology of Hypothalamo-Pituitary-Adrenal (HPA) Axis
What the sources say
- Not checked yetcites [31] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Retention of declarative memory critically depends on the integrity of the hippocampus and has been shown to benefit specifically from early nocturnal sleep, in which SWS predominates and cortisol concentrations are minimal [52, 53].”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 3. Effects of Normal Sleep on HPA Axis > 3.2. Modulatory Effects of Sleep Stages
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“No shift in the timing of the acrophase occurred, thus the duration of the rising phase of cortisol secretion was increased by nearly 3 hours and presented a biphasic pattern.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 4. Effects of Shifted Sleep on Hpa Axis > 4.2. Advance of the Sleep-Wake Cycle
What the sources say
- Not checked yetcites [68] 2002, American Journal of Physiology source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Hence, a biphasic HPA response to sleep deprivation has been suggested [63] where activation of the HPA axis, as part of the stress response, may be one of the arousal mechanisms recruited early on to adapt to sleep loss; however, when wakefulness is prolonged, the increased sleep pressure may eventually cause a blunting of the HPA axis activity.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.1. Acute Total Sleep Loss
What the sources say
- Not checked yetcites [63] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“The findings of high glucocorticoid levels in a condition of acute sleep loss have been interpreted as reflecting the stress of the effort to maintain wakefulness and is consistent with the positive correlation found between high frequency EEG activity in wake, indices of arousal, and cortisol release [63].”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.1. Acute Total Sleep Loss
What the sources say
- Not checked yetcites [63] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Even if modest, this elevation may result, under conditions of chronic sleep loss, in a significant glucocorticoid overload and consequently expose the body to the central and peripheral deleterious effects associated with glucocorticoid excess.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.2. Semichronic Partial Sleep Restriction
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“there is in turn strong evidence that elevated CRH tone increases sleep EEG frequency, thereby decreasing SWS, and increasing light sleep and wakefulness [94].”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 6. HPA Axis and Sleep Disturbances in Clinical Syndromes
What the sources say
- Not checked yetcites [94] 1988, Neuroendocrinology source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Recurrent partial sleep restriction has become a widespread habit in modern society [82]”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.2. Semichronic Partial Sleep Restriction
What the sources say
- Not checked yetcites [82] 2005, Morbidity and Mortality Weekly Report
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Findings of decreased cortisol levels after sleep deprivation have been interpreted as related to an increase in fatigue and sleepiness.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.1. Acute Total Sleep Loss
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These discrepancies could be due to a lack of control of experimental conditions, such as physical activity and posture, and/or to an insufficient frequency of blood sampling; indeed, short naps may have gone undetected and estimation of cortisol levels with infrequent blood sampling are often inaccurate.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.1. Acute Total Sleep Loss
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The timing of the period of recovery sleep is likely to have played a role in these conflicting findings.”
§ Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity > 5. Effects of Sleep Loss and Sleep Disrupion on HPA Axis > 5.1. Acute Total Sleep Loss
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
HPA hyperactivity is clearly associated with metabolic, cognitive and psychiatric disorders.
“HPA hyperactivity is clearly associated with metabolic, cognitive and psychiatric disorders”
The paper relies on this without support.
Several clinical syndromes, such as insomnia, depression, Cushing's syndrome, and sleep disordered breathing, display HPA hyperactivity, disturbed sleep, psychiatric and metabolic impairments.
“Several clinical syndromes, such as insomnia, depression, Cushing's syndrome, sleep disordered breathing (SDB) display HPA hyperactivity, disturbed sleep, psychiatric and metabolic impairments.”
The paper relies on this without support.
Sleep onset exerts a modest but clearly detectable inhibitory effect on the activity of the HPA axis.
“Given the modest but clearly detectable inhibitory effect exerted by sleep onset on the activity of the HPA axis, it has been hypothesized that sleep loss might increase cortisol levels.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“various doses of recovery sleep (0, 2, 4, 6, 8, and 10 h) following five nights of experimental sleep restriction resulted in a sleep-dose-dependent decrease of lapses (i.e., reaction times over 500 ms) in the psychomotor vigilance test”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [28]
In the citing paper
“performance did not return to baseline levels after a single night with a 10-h sleep opportunity (28) or three nights with an 8-h sleep opportunity (32), suggesting that a longer recovery sleep period is needed to fully resolve any performance decrements due to experimental sleep deficiency”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [28]
Citations
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BackgroundEpidemiologic Study of Sleep Disturbances and Psychiatric Disorders: An Opportunity for Prevention?
Ford, D. E. (1989) · JAMA · doi:10.1001/jama.1989.03430110069030 · Cited by 2,252
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“As a confirmation, lesions of the SCN in rats result in the loss of corticosteroid periodicity [15, 16].”
BackgroundA Serum Shock Induces Circadian Gene Expression in Mammalian Tissue Culture Cells
Balsalobre, A., Damiola, F., & Schibler, U. (1998) · Cell · doi:10.1016/s0092-8674(00)81199-x · Cited by 2,001 · cited 1×
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Background
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Cited by
Sorted by citations
Items 101–200 of 403
Sabanayagam, C., Zhang, R., & Shankar, A. (2012) · Cardiology Research and Practice · doi:10.1155/2012/630802 · Cited by 35
“Intermittent hypoxia and sleep fragmentation in SDB leads to insulin resistance and metabolic alterations through activation of hypothalamo-pituitary-adrenal axis [28], excessive accumulation of reactive oxygen species [29], enhanced production of proinflammatory cytokines [30], and upregulation of leptin secretion [3…”
BackgroundSleep, cognition and cortisol in addison’s disease: a mechanistic relationship
Henry, M., Thomas, K. G. F., & Ross, I. L. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.694046 · Cited by 34
“Nocturnal awakenings are associated with releases of cortisol and subsequent inhibition of cortisol secretion (34, 40, 46).”
BackgroundInfluentialA sleep state during C. elegans development
Nelson, M. D., & Raizen, D. M. (2013) · Current Opinion in Neurobiology · doi:10.1016/j.conb.2013.02.015 · Cited by 37
“On the basis of the observation that mammalian sleep deprivation is stressful [35], Driver and colleagues [32 ] investigated the role in sleep homeostasis of the gene daf-16, which encodes a FOXO transcription factor that is activated in response to stressful stimuli by movement from the cytoplasm into the nucleus [36…”
Li, L., Lu, L., Chai, J., Xiao, L., Ng, C. H., Ungvari, G. S., & Xiang, Y. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00591 · Cited by 35
“Third, there is a close association between sleep and high blood pressure since both are linked to the activities of hypothalamo-pituitary-adrenal (HPA) axis (62, 63).”
BackgroundSaleh‐Ghadimi, S., Dehghan, P., Sarmadi, B., & Maleki, P. (2022) · Journal of the Science of Food and Agriculture · doi:10.1002/jsfa.11876 · Cited by 34
The Underlying Mechanisms of Sleep Deprivation Exacerbating Neuropathic Pain
Zhu, M., & Huang, H. (2023) · Nature and Science of Sleep · doi:10.2147/nss.s414174 · Cited by 39
“In a large number of human studies, sleep onset exerts an inhibitory effect on cortisol secretion.(125) Abrupt changes in sleep”
BackgroundMetabolic syndrome – From the neurotrophic hypothesis to a theory
Hristova, M. (2013) · Medical Hypotheses · doi:10.1016/j.mehy.2013.07.018 · Cited by 32
Kim, D., Kim, H. J., Kushida, C. A., Heo, N., Ahmed, A., & Kim, W. R. (2017) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2017.08.049 · Cited by 34
“Because we excluded major etiologies of chronic liver disease, abnormal ALT levels seen in these data likely are linked to NAFLD.”
BackgroundInfluentialGlucocorticoid and inflammatory reactivity to a repeated physiological stressor in insomnia disorder
Devine, J. K., Bertisch, S. M., Yang, H., Scott‐Sutherland, J., Wilkins, A., Molina, V., Henrikson, K., & Haack, M. (2018) · Neurobiology of Sleep and Circadian Rhythms · doi:10.1016/j.nbscr.2018.06.001 · Cited by 33
“However, the relationship between insomnia and alterations in the HPA axis and inflammatory system has yet to be determined (Balbo et al., 2010; Irwin et al., 2016; Riemann 2010) as current findings are inconsistent.”
ResultImani, M. M., Sadeghi, M., Khazaie, H., Sanjabi, A., Brand, S., Brühl, A. B., & Bahmani, D. S. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.568823 · Cited by 36
“(36), it is also likely that OSAS is associated with a reduction in HPA AA, given that sleep loss, fractured sleep and hypoxemia appear to lead to an immediate autonomic activation of the organism.”
BackgroundTomfohr, L. M., Edwards, K. M., Madsen, J. W., & Mills, P. J. (2015) · Psychophysiology · doi:10.1111/psyp.12549 · Cited by 33
Ly, J., McGrath, J. J., & Gouin, J. (2015) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.03.006 · Cited by 35
“C IH R A uthor M anuscript C IH R A uthor M anuscript C IH R A uthor M anuscript slopes and 37–45% increase in cortisol levels the subsequent evening (i.e., bedtime cortisol level; Balbo et al., 2010; Leproult et al., 1997; Spiegel et al., 1999).”
BackgroundThe impact of increasing sleep restriction on cortisol and daytime sleepiness in adolescents
Voderholzer, U., Piosczyk, H., Holz, J., Feige, B., Loessl, B., Kopasz, M., Riemann, D. W., & Nissen, C. (2011) · Neuroscience Letters · doi:10.1016/j.neulet.2011.12.014 · Cited by 34
Hoyt, M. A., Mazza, M. C., Ahmad, Z. N., Darabos, K., & Applebaum, A. J. (2020) · International Journal of Behavioral Medicine · doi:10.1007/s12529-019-09842-y · Cited by 34
“Additionally, HPA axis activity has well-established relationships with various dimensions of sleep quality including nighttime awakenings [27] and poor overall sleep quality [16, 28] and might underscore disruptions in sleep quality [29, 30].”
BackgroundSzulczewski, M. T. (2021) · Neuromodulation Technology at the Neural Interface · doi:10.1111/ner.13458 · Cited by 33
Boxelaere, M. V., Clements, J., Callaerts, P., D’Hooge, R., & Callaerts‐Vegh, Z. (2017) · PLoS ONE · doi:10.1371/journal.pone.0188537 · Cited by 34
Sarafoglou, K., Merke, D. P., Reisch, N., der Grinten, H. L. C., Falhammar, H., & Auchus, R. J. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad134 · Cited by 32
Uy, J. P., & Galván, A. (2016) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2016.12.018 · Cited by 30
“Extensive research in adults has shown that sleep loss leads to similar biological outcomes as those induced by stress and amplifies physiological responses to stress (Balbo et al., 2010; Spiegel et al., 1999; Vgontzas et al., 2004).”
BackgroundAssociations between Maternal Sleep Quality Throughout Pregnancy and Newborn Birth Weight
Liu, H., Hong, L., Li, C., Chen, L., Zhang, C., Liu, Z., Wu, Y., & Huang, H. (2019) · Behavioral Sleep Medicine · doi:10.1080/15402002.2019.1702551 · Cited by 31
Yoda, K., Inaba, M., Hamamoto, K., Yoda, M., Tsuda, A., Mori, K., Yamada, S., Emoto, M., Koyama, H., & Imanishi, Y. (2013) · Diabetes Care · doi:10.2337/dc13-1102 · Cited by 31
“The activity of the HPA axis shows a clear circadian rhythm exhibiting a rapid rise during the latter half of the sleep cycle, with the highest levels occurring in the early morning (18) in parallel with the timecourse change of BP (19), suggesting the involvement of a diurnal change in HPA axis in the generation of M…”
BackgroundPathophysiology of Major Depression by Clinical Stages
de Menezes Galvão, A. C., Almeida, R. N., de Sousa, G. M., Leocadio-Miguel, M. A., Palhano-Fontes, F., de Araujo, D. B., Lobão-Soares, B., Maia-de-Oliveira, J. P., Nunes, E. A., Hallak, J. E. C., et al. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.641779 · Cited by 31
“Patients with MDD have presented changes in slow wave sleep as a result of reduction in HPA axis activity (Balbo et al., 2010).”
Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection
Ragnoli, B., Pochetti, P., Pignatti, P., Barbieri, M., Mondini, L., Ruggero, L., Trotta, L., Montuschi, P., & Malerba, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19020904 · Cited by 32
Current Challenges and Future Directions in the Assessment of Glucocorticoid Status
Clarke, S. A., Eng, P. C., Comninos, A. N., Lazarus, K., Choudhury, S., Tsang, C., Meeran, K. M., Tan, T., Dhillo, W. S., & Abbara, A. (2024) · Endocrine Reviews · doi:10.1210/endrev/bnae016 · Cited by 33
Lee, W., Jung, I., Park, S. Y., Yu, J. H., Seo, J. A., Kim, K. J., Kim, N. H., Yoo, H. J., Kim, S. G., Choi, K. M., et al. (2023) · Endocrinology and Metabolism · doi:10.3803/enm.2022.1582 · Cited by 31
“Sleep deprivation can activate the sympathetic nervous system and induce cortisol dysregulation, which is attributed to insulin resistance and visceral adiposity [39].”
BackgroundBowens, N. H., Heydendael, W., Bhatnagar, S., & Jacobson, L. (2011) · Physiology & Behavior · doi:10.1016/j.physbeh.2011.10.032 · Cited by 28
Orzeszek, S., Martynowicz, H., Smardz, J., Wojakowska, A., Bombała, W., Mazur, G. J., & Wieckiewicz, M. A. (2024) · Dental and Medical Problems · doi:10.17219/dmp/177008 · Cited by 38
Effects of sleep quality on non-alcoholic fatty liver disease: a cross-sectional survey
Takahashi, A., Anzai, Y., Kuroda, M., Kokubun, M., Kondo, Y., Ogata, T., Fujita, M., Hayashi, M., Imaizumi, H., Abe, K., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-039947 · Cited by 28
Ipsiroglu, O., Wind, K., Hung, Y.-H., Berger, M., Chan, F., Yu, W. K., Stöckler, S., & Weinberg, J. (2018) · Sleep Medicine · doi:10.1016/j.sleep.2018.10.006 · Cited by 27
Cohn, A. Y., Grant, L. K., Nathan, M., Wiley, A., Abramson, M., Harder, J., Crawford, S. L., Klerman, E. B., Scheer, F. A. J. L., Kaiser, U. B., et al. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad285 · Cited by 29
Food for Thought: Understanding the Multifaceted Nature of Orexins
Sellayah, D., & Sikder, D. S. (2013) · Endocrinology · doi:10.1210/en.2013-1488 · Cited by 26
Kim, R. H., Kim, K. I., Kim, J. H., & Park, Y. S. (2018) · Korean Journal of Family Medicine · doi:10.4082/kjfm.17.0030 · Cited by 26
Depressive symptoms and the relationship of stress, sleep, and well-being among NICU mothers
Shelton, S. L., Meaney‐Delman, D. M., Hunter, M., & Lee, S. (2014) · Journal of Nursing Education and Practice · doi:10.5430/jnep.v4n8p70 · Cited by 25
Wang, S., Rossheim, M. E., Nandy, R. R., & Nguyen, U. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.01.260 · Cited by 28
Short sleep duration preferentially increases abdominal adiposity in adults: preliminary evidence
Chaput, J., Després, J., Bouchard, C., & Tremblay, A. (2011) · Clinical Obesity · doi:10.1111/j.1758-8111.2011.00027.x · Cited by 29
“The hyperactivity of the HPA axis associated with short sleep duration (3) is one possible source of explanation for our findings.”
BackgroundObstructive sleep apnoea and dementia: is there a link?
Shastri, A., Bangar, S., & Holmes, J. (2015) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4345 · Cited by 26
“Furthermore, hypoxia may also lead to increased release of cortisol (Balbo et al., 2010).”
Backgroundvon Känel, R., Princip, M., Schmid, J., Barth, J., Znoj, H., Schnyder, U., & Meister‐Langraf, R. E. (2018) · BMC Cardiovascular Disorders · doi:10.1186/s12872-018-0947-5 · Cited by 24
Goerke, M., Cohrs, S., Rodenbeck, A., Grittner, U., Sommer, W., & Kunz, D. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.10.019 · Cited by 25
“It is still a matter of debate, however, whether SWS inhibits the activity of the HPA axis or whether decreased HPA tone promotes deep sleep (Balbo et al., 2010).”
BackgroundRao, R., Somvanshi, P. R., Klerman, E. B., Marmar, C. R., & Doyle, F. J. (2021) · Metabolites · doi:10.3390/metabo11080483 · Cited by 24
“The rising phase of the rhythm is shorter than the falling phase, with nadir of the rhythm occurring shortly before the onset of sleep [10,36], in qualitative agreement with experimental observations.”
BackgroundMethodResultInfluentialItoh, Y., Takeshima, M., Kaneita, Y., Uchimura, N., Inoue, Y., Honda, M., Yamadera, W., Watanabe, N., Kitamura, S., Okajima, I., et al. (2022) · Nature and Science of Sleep · doi:10.2147/nss.s338095 · Cited by 15
Evans, J. F., Islam, S., Urade, Y., et al. (2012) · Journal of Endocrinology · doi:10.1530/joe-12-0275 · Cited by 23
“Sleep disturbances can have a significant impact on HPA axis activity resulting in significant elevations in basal HPA hormone levels (Balbo et al. 2010).”
BackgroundSleep duration partially accounts for race differences in diurnal cortisol dynamics.
Peterson, L. M., Miller, K., Wong, P. M., Anderson, B. P., Kamarck, T. W., Matthews, K. A., Kirschbaum, C., & Manuck, S. B. (2017) · Health Psychology · doi:10.1037/hea0000468 · Cited by 23
“Some studies failed to find a relationship between sleep characteristics and cortisol indices (reviewed in Balbo et al., 2010), but our finding that shorter total sleep time associates with a flatter diurnal slope is consistent with laboratory and observation studies.”
Peters, A. C., Jens Blechert, A., Sämann, P. G., Eidner, I., Czisch, M., & Spoormaker, V. I. (2014) · Journal of Neurophysiology · doi:10.1152/jn.00657.2013 · Cited by 24
“In healthy humans, cortisol secretion adheres to a 24-h profile with a steep increase during the second half of the night, high levels in the early morning, and a progressive decline throughout the rest of the day (Balbo et al. 2010).”
Can treatment of obesity reduce depression or vice versa?
Borgland, S. L. (2021) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.210036 · Cited by 27
Yap, Y., Tung, N. Y. C., Shen, L., Bei, B., Phillips, A. J. K., & Wiley, J. F. (2024) · SLEEP · doi:10.1093/sleep/zsae087 · Cited by 25
“Previous studies have found that nighttime awakenings are associated with a subsequent increase in cortisol levels, followed by a temporary inhibition of cortisol secretion [3, 55].”
BackgroundNon-alcoholic fatty liver disease and sleep disorders
Bu, L.-F., Xiong, C.-Y., Zhong, J.-Y., Xiong, Y., Li, D., Hong, F., & Yang, S. (2024) · World Journal of Hepatology · doi:10.4254/wjh.v16.i3.304 · Cited by 22
Chew the Pain Away: Oral Habits to Cope with Pain and Stress and to Stimulate Cognition
Weijenberg, R. A. F., & Lobbezoo, F. (2015) · BioMed Research International · doi:10.1155/2015/149431 · Cited by 23
“Sleep and the circadian rhythm also influence the HPA axis activity [38, 39] and finally one must keep in mind that cortisol levels also are not stable during the waking hours but exhibit ultradian oscillations [39].”
BackgroundMohammadi, S. A., Burton, T. J., & Christie, M. J. (2017) · Behavioural Brain Research · doi:10.1016/j.bbr.2017.04.005 · Cited by 23
“Circadian disruption and HPA-axis dysregulation are closely linked [101] and this dysregulation is characteristic of affective disorders, in particular major depression [102,103].”
Sabanayagam, C., Teppala, S., & Shankar, A. (2012) · International Journal of Endocrinology · doi:10.1155/2012/879134 · Cited by 22
“Intermittent hypoxia and sleep fragmentation in SDB leads to insulin resistance and metabolic alterations through activation of hypothalamo-pituitary-adrenal axis [28], excessive accumulation of reactive oxygen species [29], enhanced production of proinflammatory cytokines [30], and upregulation of leptin secretion [3…”
BackgroundSleep Fragmentation Has Differential Effects on Obese and Lean Mice
He, J., Kastin, A. J., Wang, Y., & Pan, W. (2014) · Journal of Molecular Neuroscience · doi:10.1007/s12031-014-0403-7 · Cited by 20
Tsai, J.-C., Chou, K., Tsai, H., Yen, Y., & Niu, S. (2019) · Biological Research For Nursing · doi:10.1177/1099800419861695 · Cited by 24
Argyriou, A. A., Karanasios, P. I., Assimakopoulos, K., Iconomou, G., Makridou, A., Giannakopoulou, F., & Makris, N. (2011) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2011.01.005 · Cited by 20
Jackson, C. L., Gaston, S. A., Liu, R., Mukamal, K. J., & Rimm, E. B. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15030557 · Cited by 20
“Sleep deprivation, a result of habitual suboptimal sleep duration, is also hypothesized to elevate nocturnal cortisol over time [47].”
BackgroundPsychological Co-morbidities of Obesity
Pagoto, S., Schneider, K. L., Appelhans, B. M., Curtin, C., & Hajduk, A. M. (2011) · Springer eBooks · doi:10.1007/978-1-4419-0029-6_1 · Cited by 21
Li, X., He, Y., Wang, D., & Momeni, M. R. (2024) · Clinical and Experimental Medicine · doi:10.1007/s10238-024-01514-w · Cited by 28
“Furthermore, sleep deprivation or fragmentation can esca-late sympathetic nervous system activity, trigger the hypo-thalamic—pituitary—adrenal axis, and prolong the release of nocturnal growth hormone [107].”
Sleep deprivation-induced shifts in gut microbiota: Implications for neurological disorders
Wankhede, N. L., Kale, M. B., Kyada, A., Rekha, M. M., Chaudhary, K., Naidu, K. S., Rahangdale, S. R., Shende, P. V., Taksande, B. G., Khalid, M., et al. (2024) · Neuroscience · doi:10.1016/j.neuroscience.2024.11.070 · Cited by 21
Zhang, J., Zhang, J., Wu, H., & Wang, R. (2021) · Sleep And Breathing · doi:10.1007/s11325-021-02504-y · Cited by 20
“Poor sleep quality and prolonged sleep latency have been proven to activate the HPA axis, which triggers the secretion of stress hormones [11, 12], raising the possibility of hyperlipidemia.”
BackgroundChang, X., Guo, C., Heng, Z., & Liu, L. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04572-8 · Cited by 24
“, catecholamine, cortisol), raising the risk of metabolic syndrome [16, 17].”
BackgroundAuvinen, H. E., Coomans, C. P., Boon, M. R., Romijn, J. A., Biermasz, N. R., Meijer, O. C., Havekes, L. M., Smit, J. W. A., Rensen, P. C. N., & Pereira, A. M. (2013) · Physiological Reports · doi:10.1002/phy2.103 · Cited by 19
“Epidemiological data also indicate an increased prevalence of the MetS in conditions associated with alterations in the HPA axis, like in anxiety and depression, after medical treatment with GC, and also in sleep disorders (Balbo et al. 2010; Sahar and SassoneCorsi 2012).”
BackgroundSleep duration buffers diurnal cortisol increases in older adulthood
Rueggeberg, R., Wrosch, C., & Miller, G. E. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.11.012 · Cited by 21
“To this end, we suggest that sleep duration could be one such factor that has the potential to influence trajectories of older adults’ diurnal cortisol secretion (Balbo et al., 2010).”
Golmohammadi, M., Attari, V. E., Salimi, Y., Saed, L., Nachvak, S. M., & Samadi, M. (2025) · Scientific Reports · doi:10.1038/s41598-025-91389-y · Cited by 25
Shu, P., Ji, L., Ping, Z., Sun, Z., & Liu, W. (2022) · Frontiers in Genetics · doi:10.3389/fgene.2022.938334 · Cited by 20
“Moreover, individuals with insomnia symptoms have a mild increase in basal cortisol levels and a hyper-reactivity of the Hypothalamus-pituitaryadrenal axis, which are associated with pain sensitivity (Balbo et al., 2010; Goodin et al., 2012).”
BackgroundSleep duration and progression to diabetes in people with prediabetes defined by HbA1c concentration
Kim, C., Chang, Y., Sung, E., & Ryu, S. (2017) · Diabetic Medicine · doi:10.1111/dme.13432 · Cited by 19
Andrews, N. E., Strong, J., & Meredith, P. J. (2015) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000226 · Cited by 19
Frailty and sleep disturbances in the elderly: possible connections and clinical implications
Piovezan, R. D., Poyares, D. R., & Tufik, S. (2013) · Sleep Science · doi:10.1055/s-0046-1820411 · Cited by 17
“Sleep disturbances affects hypothalamus-pituitary-adrenal axis and hypothalamic-pituitary-gonadal axis functions (48) .”
Comprehensive Strategies to Reduce Readmissions in Older Patients With Cardiovascular Disease
Dharmarajan, K. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.01.030 · Cited by 17
Weitzer, J., Papantoniou, K., Lázaro‐Sebastià, C., Seidel, S., Klösch, G., & Schernhammer, E. S. (2020) · Journal of Sleep Research · doi:10.1111/jsr.13132 · Cited by 16
“Whereas hyperactivity of the HPA axis resulting in higher cortisol levels may provoke poor sleep and is associated with higher insomnia risk, conversely, insomnia symptoms may increase cortisol levels, triggering a vicious circle (Balbo et al., 2010).”
BackgroundAssessing Whether the Association Between Sleep Apnea and Diabetes is Bidirectional
Liu, C., & Wu, C. (2016) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2016.09.009 · Cited by 18
Yan, Y. R., Zhang, L., Lin, Y. N., Wei, Y., Li, N., Sun, X. W., Zhou, J., & Li, Q. Y. (2019) · The American Journal of the Medical Sciences · doi:10.1016/j.amjms.2019.03.004 · Cited by 16
The impact of prior day sleep and physical activity on the cortisol awakening response
Anderson, T., Corneau, G. M., Wideman, L., Eddington, K. M., & Vrshek‐Schallhorn, S. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105131 · Cited by 20
Lin, Y., Jen, H., Lin, Y., Seo, J., & Chang, W. (2022) · BioMed Research International · doi:10.1155/2022/9506583 · Cited by 14
“also indicted that working at night results in lower cortisol levels in the morning after, but after the fifth night of working at night, cortisol levels will become the inverse of the original day-night cycle [6].”
Tuan, L., Yeh, J.-W., Lee, L. J., & Lee, L. (2023) · Molecular Neurobiology · doi:10.1007/s12035-023-03258-2 · Cited by 17
“Mounting evidence suggested a reciprocal relationship between sleep loss and stress responses [27, 57].”
BackgroundTimofticiuc, D. C. P., Bădescu, D., Moța, M., Ștefan, A. G., Mitrea, A., Clenciu, D., Efrem, I. C., Roșu, M. M., Vladu, B. E., Gheonea, T. C., et al. (2024) · Nutrients · doi:10.3390/nu16234057 · Cited by 20
“Additionally, factors such as inflammatory cytokines and the hypothalamic–pituitary–adrenal (HPA) axis have been linked to sleep physiology [54,55].”
Cortisol Awakening Response: An Ancient Adaptive Feature
Contreras, C. M., & Gutiérrez‐García, A. G. (2018) · Journal of Psychiatry and Psychiatric Disorders · doi:10.26502/jppd.2572-519x0038 · Cited by 15
Vigilance States: Central Neural Pathways, Neurotransmitters and Neurohormones
Iovino, M., Messana, T., Pergola, G. D., Iovino, E., Guastamacchia, E., Giagulli, V. A., & Triggiani, V. (2018) · Endocrine Metabolic & Immune Disorders - Drug Targets · doi:10.2174/1871530318666180816115720 · Cited by 13
Cheng, W., Chen, H., Tian, L., Ma, Z., & Cui, X. (2023) · Frontiers in Physiology · doi:10.3389/fphys.2023.1157270 · Cited by 18
“In addition to affecting the activity of ANS, sleep also exerts a significant regulatory effect on glycemic control by influencing the balance and levels of hormones including leptin, growth hormonereleasing peptide, insulin and cortisol (Balbo et al., 2010), which enhances the association between HRV metrics during s…”
BackgroundMedicinal Plants Combating Against Insomnia
Akram, M., Daniyal, M., Munir, N., Mohiuddin, E., & Sultana, S. (2019) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001052 · Cited by 14
“Altered sleep wake cycle, in sleep disorder, significantly affects the daily cortisol rhythm and other circulatory hormones like catecholamine which may increase the risk of development of insomnia associated diabetes, obesity and cognitive dysfunction (Balbo et al., 2010).”
BackgroundSleep Disturbance during Infection Compromises Tfh Differentiation and Impacts Host Immunity
Fernandes, E. R., Barbosa, M. L., Amaral, M. P., Apostólico, J. D. S., Sulczewski, F. B., Tufik, S., Andersen, M. L., Boscardin, S. B., Keller, A. C., & Rosa, D. S. (2020) · iScience · doi:10.1016/j.isci.2020.101599 · Cited by 15
Impact of shift work on sleep and fatigue in Maritime pilots
Tait, J. L., Chambers, T. P., Tait, R. S., & Main, L. C. (2021) · Ergonomics · doi:10.1080/00140139.2021.1882705 · Cited by 16
Smaliukienė, R., Bekešienė, S., Mažeikienė, A., Larsson, G., Karčiauskaitė, D., Mazgelytė, E., & Vaičaitienė, R. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031663 · Cited by 16
“According to Balbo [15], cortisol causes a number of physiological changes during a stress response process.”
BackgroundDeterminant factors of depression in beta major thalassemia children
Suryawan, A., Ningtiar, H. W., Irwanto, I., et al. (2021) · Folia Medica Indonesiana · doi:10.20473/fmi.v57i1.13664 · Cited by 13
“This effect was seen in the secretory response of adrenocortical after trauma (Balbo et al 2010).”
BackgroundGu, C., Zhai, M., Lü, A., et al. (2022) · PubMed · doi:10.12122/j.issn.1673-4254.2022.12.08 · Cited by 13
Wang, D., Wu, T., Jin, J., Si, Y., Wang, Y., Ding, X., Guo, T., & Wei, W. (2024) · Molecules · doi:10.3390/molecules29153638 · Cited by 14
“Sleep has a close and reciprocal The hypothalamic–pituitary–adrenal (HPA) axis plays important roles in modulating sleep. association with the ability of the HPA axis to operate [30].”
BackgroundTatikola, S. P., Natarajan, V., Amaravadi, S. K., Desai, V. K., Asirvatham, A. R., & Nagaraja, R. (2024) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2024.11.016 · Cited by 16
Xiao, J., Wang, R., Hu, Y., He, T., Ruan, Z., Chen, Q., & Peng, Z. (2022) · BMC Psychology · doi:10.1186/s40359-022-00789-6 · Cited by 13
“Overactivation of the HPA axis increases shallow sleep and night wakefulness of individuals, while insufficient sleep increases the basic activities of the HPA axis, inducing neuroendocrine changes and affecting the function of the HPA axis [52, 53].”
BackgroundPark, K.-M., Kim, S.-Y., Sung, D., Kim, H., Kim, B.-N., Park, S., Jung, K.-I., & Park, M.-H. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.112504 · Cited by 19
The Role of Sleep Disturbance, Depression and Anxiety in Frail Patients with AF–Gender Differences
Jankowska‐Polańska, B., Polański, J., Dudek, K. D., Sławuta, A., Mazur, G. J., & Gajek, J. J. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm10010011 · Cited by 12
“, also play a part in the pathophysiology of frailty in older adults [5,6,10].”
BackgroundLiu, J., Zhang, T., Luo, J., Chen, S., & Zhang, D. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043416 · Cited by 15
“Second, a previous study has found that sleep duration was associated with the production of growth hormone, insulin-like growth factor 1, and testosterone, which in turn might affect muscle function [11].”
BackgroundCen, Y., He, J., Zhong, Y., Zhou, J., Zeng, J., Huang, G., & Luo, J. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05503-x · Cited by 13
“Also, the HPA axis plays a role in sleep regulation and sleep disorders, and its activation can negatively affect sleep [42].”
BackgroundRaggi, M., Moore, L. J., & Mesin, L. (2025) · IEEE Access · doi:10.1109/access.2025.3528518 · Cited by 14
Thorsley, D., Leproult, R., Spiegel, K., & Jaques Reifman, A. (2012) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00271.2012 · Cited by 12
“Instead, most of the understanding of the effects of sleep duration on cortisol production is at a qualitative, phenomenological level (2).”
BackgroundSelf-citationAl-Farsi, H. Y., Al-Fahdi, E. Y., Al-Balushi, M. A., Al-Jahwari, A. N., Al-Maskari, A., & Das, S. (2025) · Current Medicinal Chemistry · doi:10.2174/0109298673350476250331181123 · Cited by 12
Associations between metabolic disorders and sleep disturbance in patients with schizophrenia
Yan, H., Huang, Z., Lu, Y., Qiu, Y., Li, M., & Li, J. (2023) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2023.152369 · Cited by 11
Association of sleep duration and prevalence of sarcopenia: A large cross-sectional study
Zhang, G., Wang, D., Chen, J., Tong, M., Wang, J., Chang, J., & Xiaoping, G. (2024) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2024.102741 · Cited by 11
“Primarily, investigations indicate that sleep duration exerts influence over hormonal equilibrium, notably impacting the secretion of growth hormone, a key regulator in muscle growth, repair, and maintenance (Balbo et al., 2010).”
Endocrine, Lifestyle, and Genetic Factors in the Development of Metabolic Syndrome
Slanovic-Kuzmanović, Z., Kos, I., & Domijan, A. (2013) · Archives of Industrial Hygiene and Toxicology · doi:10.2478/10004-1254-64-2013-2327 · Cited by 11
“The internal biological clock is primarily aligned with the light/dark cycle, but is also affected by other factors such as locomotor activity and food intake (35-37).”
BackgroundSleep Disturbances and Physical Impairment: A Systematic Review and Meta-Analysis
Amiri, S., & Behnezhad, S. (2021) · Physical & Occupational Therapy In Geriatrics · doi:10.1080/02703181.2021.1871699 · Cited by 10
Rosalky, D. S., Hostler, D. P., & Webb, H. E. (2016) · Applied Ergonomics · doi:10.1016/j.apergo.2016.04.008 · Cited by 13
Treating insomnia in patients with comorbid psychiatric disorders: A focused review.
Garland, S. N., Vargas, I., Grandner, M. A., & Perlis, M. L. (2018) · Canadian Psychology/Psychologie canadienne · doi:10.1037/cap0000141 · Cited by 12
Cai, X.-F., Wang, B., Zhao, J.-M., Nian, M.-X., Lin, Q.-C., & Huang, J. (2024) · Scientific Reports · doi:10.1038/s41598-024-78123-w · Cited by 11
Kiss, O., Harkness, A., Müller‐Oehring, E. M., Nagata, J. M., & Baker, F. C. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119883 · Cited by 10
Tao, H., Zeng, X., Hou, M., Chen, S., Shen, J., Liao, X., & Zou, C. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1134631 · Cited by 12
Metadata
- Authors
- Balbo, M., Leproult, R., & Van Cauter, E.
- Affiliations
- University of Chicago (US)
- Sleep, Chronobiology and Neuroendocrinology Research Laboratory, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
- ORCID
- Leproult, Rachel
- Venue
- International Journal of Endocrinology
- Publisher
- Wiley
- Published
- 2010
- Volume
- 2010
- Pages
- 1-16
- ISSN
- 1687-8337 (ISSN-L)
- 1687-8345
- PMC
- PMC2902103
- OpenAlex
- W2013718939
- Semantic Scholar
- 222089b5db5564615cd54a1b79fae94417205c62
- Cited by
- 408
- References
- 155
- Citations by year
- 2026: 50 · 2025: 43 · 2024: 40 · 2023: 31 · 2022: 26 · 2021: 32 · 2020: 19 · 2019: 22 · 2018: 24 · 2017: 17 · 2016: 14 · 2015: 21 · 2014: 16 · 2013: 17 · 2012: 20
- FWCI
- 7.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- International Journal of Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- sleep, sleep disorders, hypothalamic-pituitary-adrenal axis, cortisol secretion, circadian rhythm, sleep deprivation, sleep quality, insomnia, depression, Cushing's syndrome, sleep-disordered breathing, obesity, diabetes mellitus, cognitive impairment
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