The DOI matches its Crossref record; 43 of the 46 references it cites were found in a registry or an index; none of the 78 sources its claims cite is checked for support yet.
Adverse Effects of Two Nights of Sleep Restriction on the Hypothalamic-Pituitary-Adrenal Axis in Healthy Men
Open accessAbstract
CONTEXT: Insufficient sleep is associated with increased cardiometabolic risk. Alterations in hypothalamic-pituitary-adrenal axis may underlie this link. OBJECTIVE: Our objective was to examine the impact of restricted sleep on daytime profiles of ACTH and cortisol concentrations. METHODS: Thirteen subjects participated in 2 laboratory sessions (2 nights of 10 hours in bed versus 2 nights of 4 hours in bed) in a randomized crossover design. Sleep was polygraphically recorded. After the second night of each session, blood was sampled at 20-minute intervals from 9:00 am to midnight to measure ACTH and total cortisol. Saliva was collected every 20 minutes from 2:00 pm to midnight to measure free cortisol. Perceived stress, hunger, and appetite were assessed at hourly intervals by validated scales. RESULTS: Sleep restriction was associated with a 19% increase in overall ACTH levels (P < .03) that was correlated with the individual amount of sleep loss (rSp = 0.63, P < .02). Overall total cortisol levels were also elevated (+21%; P = .10). Pulse frequency was unchanged for both ACTH and cortisol. Morning levels of ACTH were higher after sleep restriction (P < .04) without concomitant elevation of cortisol. In contrast, evening ACTH levels were unchanged while total and free cortisol increased by, respectively, 30% (P < .03) and 200% (P < .04). Thus, the amplitude of the circadian cortisol decline was dampened by sleep restriction (-21%; P < .05). Sleep restriction was not associated with higher perceived stress but resulted in an increase in appetite that was correlated with the increase in total cortisol. CONCLUSION: The impact of sleep loss on hypothalamic-pituitary-adrenal activity is dependent on time of day. Insufficient sleep dampens the circadian rhythm of cortisol, a major internal synchronizer of central and peripheral clocks.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
Two nights of sleep restriction to 4 hours in bed increased daytime HPA-axis activity in healthy young men, with higher overall ACTH and a trend toward higher total cortisol. The effect varied by time of day: morning ACTH rose without cortisol, while evening total and free cortisol rose without ACTH, dampening the circadian cortisol decline.
Key findings
- Sleep restriction increased overall daytime ACTH by 19% (P < .03) and total cortisol by 21% (P = .10); the ACTH increase correlated with the amount of sleep loss (rSp = 0.63, P < .02).
- Morning ACTH was 10% higher after sleep restriction (P < .04) without a significant morning cortisol elevation, whereas evening total cortisol increased by 30% (P < .03) and evening free cortisol by 200% (P < .04) without an evening ACTH increase.
- The circadian decline in total cortisol was dampened by 21% (P < .05); pulse frequency was unchanged for ACTH and cortisol, though ACTH pulse trough and peak values were higher (both P < .05).
- Perceived stress did not differ between conditions, but increased appetite correlated with increased total cortisol (rSp = 0.67, P < .04; hunger rSp = 0.60, P < .06).
Methods
- Thirteen healthy young men (median age 21 [20; 23] years; BMI 24.6 [21; 25] kg/m²) completed a randomized crossover study with two laboratory sessions: 2 nights of 10 hours in bed vs 2 nights of 4 hours in bed, spaced at least 6 weeks apart.
- After the second night of each session, blood was sampled every 20 minutes from 9:00 am to midnight for ACTH and total cortisol, and saliva every 20 minutes from 2:00 pm to midnight for free cortisol; participants received constant glucose infusion and remained recumbent.
- Analyses used Wilcoxon exact rank tests, mixed-effects ANOVA for serial hormone data, Spearman correlations, and the ULTRA algorithm for pulse detection.
Limitations
- The paper states: small sample size; only young men, so findings cannot be extrapolated to the general population; constant glucose infusion instead of meals does not mimic real-life conditions; and sleep restriction lasted only 2 nights, so results may not translate to chronic sleep debt.
- Evident from the text: the controlled laboratory setting and exclusion of women, smokers, and medicated individuals limit generalizability to everyday sleep restriction contexts.
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Claims the paper makes
43 Own result · 28 Not checked yet · 12 Own method · 11 Own interpretation · 3 No basis given
A 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 contrast, evening ACTH levels were unchanged while total and free cortisol increased by, respectively, 30% (P < .03) and 200% (P < .04).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A 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
“Morning levels of ACTH were higher after sleep restriction (P < .04) without concomitant elevation of cortisol.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A 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 contrast, evening ACTH levels were unchanged while total and free cortisol increased by, respectively, 30% (P < .03) and 200% (P < .04).”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A 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
“Pulse frequency was unchanged for both ACTH and cortisol.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A 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
“Morning levels of ACTH were higher after sleep restriction (P < .04) without concomitant elevation of cortisol.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A 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
“Sleep restriction was associated with a 19% increase in overall ACTH levels (P < .03) that was correlated with the individual amount of sleep loss (rSp = 0.63, P < .02).”
- Also stated in: § Results · plain
“overall daytime ACTH levels during short sleep were 19% (10%; 24%) higher (AUC 9:00 am to midnight, 10 551 [5575; 13 821] vs 7481 [5104; 12418] pg/mL/min, P < .03)”
- Also stated in: § Results · plain
“short sleep was associated with increased overall ACTH (F = 5.6, P < .04)”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Results · plain
A 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
“Sleep restriction was associated with a 19% increase in overall ACTH levels (P < .03) that was correlated with the individual amount of sleep loss (rSp = 0.63, P < .02).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A 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
“Sleep restriction was not associated with higher perceived stress but resulted in an increase in appetite that was correlated with the increase in total cortisol.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A 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 contrast, evening ACTH levels were unchanged while total and free cortisol increased by, respectively, 30% (P < .03) and 200% (P < .04).”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A 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
“Mixed-effects ANOVA confirmed these findings; short sleep was associated with increased overall ACTH (F = 5.6, P < .04) and with a trend for increased overall serum cortisol (F = 3.0, P = .11), and a condition × time of day interaction was found for plasma ACTH (F = 1.4, P < .05) but not for serum cortisol (F = 0.9, P = .67).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 24
- Probably not a substantial claim. 28
A 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
“Overall total cortisol levels were also elevated (+21%; P = .10).”
- Also stated in: § Results · hedged
“there was a trend for a similar increase (ie, +21% [−6%; +41%]) in total cortisol (6844 [6308; 7324] vs 4826 [4519; 7240] μg/dL/min, P = .10)”
- Also stated in: § Results · hedged
“with a trend for increased overall serum cortisol (F = 3.0, P = .11)”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Results · hedged
A 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
“but not of total (rSp = −0.27, P = .36) or free cortisol (rSp = −0.20, P = .52).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A 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
“Similar results were obtained when we analyzed scores obtained in the morning (9:00 am to 1:00 pm, 7 [6; 8] vs 7 [6; 8], P = .27, 2 [1; 3] vs 2 [1; 3], P = .27; and 1 [1; 2] vs 1 [1; 2], P = .50) or in the evening (8:00 pm to midnight; P > .34).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A 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 overall mean scores for calm, tense and nervous were similar in both sleep conditions (7 [5; 8] vs 7 [6; 8], P = .42; 2 [1; 3] vs 2 [1;3], P = .15; and 1 [1; 1] vs 1 [1; 1[, P = .34, respectively).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A 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 resulting daily variations of cortisol are characterized by an increase in evening total (+30%) and free cortisol levels (+200%).”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A 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
“Over the entire sampling period, the number of ACTH pulses as well as the number, mean trough, and peak and absolute increment of pulses of total and free cortisol were unaffected by the sleep condition.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Consistent with our previous study of 6 nights of sleep restriction (15), we found that levels of perceived stress in the present study remained low and were not affected by sleep loss.”
What the sources say
- Not checked yetcites [15] Spiegel, 2004, Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin, J Clin Endocrinol Metab source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Habitual short sleep, usually 6 hours or less, has been linked in epidemiological studies to increased mortality and increased prevalence and incidence of numerous pathological conditions including obesity, diabetes, cardiovascular diseases, vulnerability to infection, depression, and anxiety (3–10).”
What the sources say
- Not checked yetcites [3] Spiegel, 2009, Effects of poor and short sleep on glucose metabolism and obesity risk, Nat Rev
- Not checked yetcites [4] Cappuccio, 2010, Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis, Diabetes Care source
- Not checked yetcites [5] Cappuccio, 2011, Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies, Eur Heart J source
- Not checked yetcites [6] Nielsen, 2011, Short sleep duration as a possible cause of obesity: critical analysis of the epidemiological evidence, Obes Rev source
- Not checked yetcites [7] Morselli, 2012, Sleep and metabolic function, Pflugers Arch source
- Not checked yetcites [8] Faraut, 2012, Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery, Sleep Med Rev source
- Not checked yetcites [9] Cappuccio, 2013, Sleep and mortality: cause, consequence, or symptom?, Sleep Med source
- Not checked yetcites [10] Alvaro, 2013, A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression, Sleep source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Indeed, not only the levels of cortisol but also its variation across the day play a role for health and disease (20, 21).”
What the sources say
- Not checked yetcites [20] Chung, 2011, Circadian rhythm of adrenal glucocorticoid: its regulation and clinical implications, Biochim Biophys Acta source
- Not checked yetcites [21] Plat, 1999, Metabolic effects of short-term elevations of plasma cortisol are more pronounced in the evening than in the morning, J Clin Endocrinol Metab
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The other examined the impact of 2 nights of 4 hours in bed vs 2 nights of 8 hours in bed and found no differences in either ACTH or cortisol (22).”
What the sources say
- Not checked yetcites [22] Schmid, 2011, Disturbed glucoregulatory response to food intake after moderate sleep restriction, Sleep source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the subjects participated in 2 laboratory sessions in randomized order.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It 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
“Insufficient sleep is associated with increased cardiometabolic risk.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Perceived stress, hunger, and appetite were assessed at hourly intervals by validated scales.”
What the sources say
- Not checked yetcites [23] Monk, 1989, A visual analogue scale technique to measure global vigor and affect, Psychiatry Res source
- Not checked yetcites [24] Clark, 1989, Diurnal variation in the positive affects, Motivation Emotion source
- Not checked yetcites [25] Stubbs, 2000, The use of visual analogue scales to assess motivation to eat in human subjects: a review of their reliability and validity with an evaluation of new hand-held computerized systems for temporal tracking of appetite ratings, Br J Nutr source
- Not checked yetcites [26] Fernstrom, 1987, Appetite and food preference in depression: effects of imipramine treatment, Biol Psychiatry source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For each hormone, all samples from the same subject were measured in the same assay.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Plasma ACTH and serum cortisol were measured by immunochemiluminometric assay (Immulite; Siemens). The limit of sensitivity of the ACTH assay was 1 pg/mL, and the coefficient of intra-assay variation was ≤9.6%. The limit of sensitivity of the cortisol assay was 1.0 μg/dL, and the coefficient of intra-assay variation was 5% on average (21).”
What the sources say
- Not checked yetcites [21] Plat, 1999, Metabolic effects of short-term elevations of plasma cortisol are more pronounced in the evening than in the morning, J Clin Endocrinol Metab
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It 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
“A complete assessment of the HPA axis requires the measurement of both ACTH and cortisol levels at frequent intervals across the day.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Because the hypothalamic-pituitary-adrenal (HPA) axis regulates a wide range of physiologic processes and is affected by experimental sleep restriction, it is a putative key mediator of the adverse health effects of insufficient sleep (3–11).”
What the sources say
- Not checked yetcites [3] Spiegel, 2009, Effects of poor and short sleep on glucose metabolism and obesity risk, Nat Rev
- Not checked yetcites [4] Cappuccio, 2010, Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis, Diabetes Care source
- Not checked yetcites [5] Cappuccio, 2011, Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies, Eur Heart J source
- Not checked yetcites [6] Nielsen, 2011, Short sleep duration as a possible cause of obesity: critical analysis of the epidemiological evidence, Obes Rev source
- Not checked yetcites [7] Morselli, 2012, Sleep and metabolic function, Pflugers Arch source
- Not checked yetcites [8] Faraut, 2012, Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery, Sleep Med Rev source
- Not checked yetcites [9] Cappuccio, 2013, Sleep and mortality: cause, consequence, or symptom?, Sleep Med source
- Not checked yetcites [10] Alvaro, 2013, A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression, Sleep source
- Not checked yetcites [11] Chrousos, 2007, Glucocorticoid action networks and complex psychiatric and/or somatic disorders, Stress source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“only 4 naps, lasting 121 minutes in total, were detected in the 4-hours-in-bed condition in a single subject.”
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Prestudy TIB and TST did not differ between the 2 experimental conditions (P = .16 and P = .42, respectively).”
plainn = 13- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
“Alterations in hypothalamic-pituitary-adrenal axis may underlie this link.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
In the paper
“One study found increased evening cortisol levels in the face of unchanged ACTH levels after 5 nights of 4 hours in bed in comparison with 2 nights of 10 hours in bed (19).”
What the sources say
- Not checked yetcites [19] Reynolds, 2012, Impact of five nights of sleep restriction on glucose metabolism, leptin and testosterone in young adult men, PloS One source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Sampling started 1 hour after catheter insertion to avoid observing the effect of the venipuncture stress on ACTH and cortisol levels.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Free cortisol in saliva was measured by RIA (Coat-A-Count; Diagnostic Products Corporation) following the manufacturer's directions. The limit of sensitivity of the assay was 0.025 μg/dL, and the coefficient of intra-assay variation averaged 4%.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Third, our participants received a constant glucose infusion instead of 3 meals, an experimental condition that does not mimic real-life conditions.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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
“We found that 2 nights of 4 hours in bed were associated with spontaneous HPA axis hyperactivity, because overall daytime levels of ACTH were increased by 19% and total cortisol tended to increase by 21%.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“These elevated cortisol levels at a time when cortisol is usually low are likely to adversely affect the numerous physiological processes modulated by the final product of the HPA axis.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
In the paper
“In animals, intracerebroventricular injection of orexins activates the HPA axis by increasing CRH release in the paraventricular nucleus of the hypothalamus (35).”
What the sources say
- Not checked yetcites [35] Rohleder, 2007, Effects of nutrition on neuro-endocrine stress responses, Curr Opin Clin Nutr Metab Care source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
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
“Sleep loss therefore acts as a mild physiological, but not psychological, stressor, because measures of perceived stress remained unaffected by sleep loss.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“In addition to this overall mild hyperactivity, we found that sleep loss differently affected ACTH and cortisol levels according to the time of day, suggesting that sleep loss alters the circadian modulation of the sensitivity of the adrenals to ACTH.”
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Orexins are synthesized by neurons in the lateral hypothalamus and stimulate arousal and feeding (36).”
What the sources say
- Not checked yetcites [36] Mieda, 2012, Overview of orexin/hypocretin system, Prog Brain Res source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“It is possible that the 20-minute sampling frequency used in our study was insufficient to detect changes in ACTH pulse frequency (30).”
What the sources say
- Not checked yetcites [30] Iranmanesh, 1990, Intensive venous sampling paradigms disclose high frequency adrenocorticotropin release episodes in normal men, J Clin Endocrinol Metab source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“These results suggest that adrenal sensitivity to ACTH may be reduced in the morning and, as previously suggested (19), enhanced in the evening in a state of sleep loss.”
What the sources say
- Not checked yetcites [19] Reynolds, 2012, Impact of five nights of sleep restriction on glucose metabolism, leptin and testosterone in young adult men, PloS One source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Lastly, sleep restriction was applied for only 2 nights, and the results may not translate to states of chronic sleep debt, although in a well-documented prospective epidemiologic study in 2802 older adults, short sleep predicted higher daytime cortisol levels (42).”
What the sources say
- Not checked yetcites [42] Kumari, 2010, Identifying patterns in cortisol secretion in an older population. Findings from the Whitehall II study, Psychoneuroendocrinology source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Second, we studied only young men and the data cannot, therefore, be extrapolated to the general population.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Evidence is rapidly accumulating to indicate that misalignment between central and peripheral clocks has a host of adverse effects, including an increased risk of obesity and type 2 diabetes (37, 39).”
What the sources say
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“First, the sample size is small.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Lastly, we complemented our hormonal analysis with repeated assessments of self-reported levels of stress, hunger, and appetite using validated instruments.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Third, we collected blood and saliva samples at frequent intervals throughout the day, allowing us to evaluate the effects of sleep loss on both the pulsatile and circadian variations.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. 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
“Irrespective of the underlying mechanisms, these alterations in HPA functioning may mediate the association between short sleep and increased risk for various conditions, including obesity, diabetes, cardiovascular diseases, vulnerability to infection, depression, and anxiety.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
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 increase in cortisol levels was correlated with increased appetite, highlighting the close relationship between the regulation of arousal, energy homeostasis, and the HPA axis.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Second, we assessed both ACTH and total as well as free cortisol, therefore allowing a complete assessment of the HPA axis.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“although in a well-documented prospective epidemiologic study in 2802 older adults, short sleep predicted higher daytime cortisol levels (42).”
What the sources say
- Not checked yetcites [42] Kumari, 2010, Identifying patterns in cortisol secretion in an older population. Findings from the Whitehall II study, Psychoneuroendocrinology source
boostedcorrelationaln = 2,802- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“First, we used a randomized crossover design with rigorously controlled experimental conditions.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper relies on this without support.
The role of ACTH levels in the evening elevation of cortisol secretion after sleep loss has not been elucidated.
“The role of ACTH levels in this evening elevation of cortisol secretion has not been elucidated.”
The paper relies on this without support.
Cortisol is a major internal synchronizer of central and peripheral clocks.
“Insufficient sleep dampens the circadian rhythm of cortisol, a major internal synchronizer of central and peripheral clocks.”
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Findings of elevated expression and release of CRH in sleep-deprived rodents [38][39][40] and of elevated baseline ACTH levels in sleep-deprived humans in the present and in a previous study 16 suggest that partial pituitary desensitization to CRH is likely the consequence of sustained elevated CRH release.”
From Effects of Insufficient Sleep on Pituitary–Adrenocortical Response to CRH Stimulation in Healthy Men (2017) · cites this paper as [16]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“a recent study in healthy humans reported elevated daytime ACTH levels following 2 nights of 4 hours in bed, therefore providing evidence for an up-regulation of the HPA axis during severe sleep loss in humans.16”
From Effects of Insufficient Sleep on Pituitary–Adrenocortical Response to CRH Stimulation in Healthy Men (2017) · cites this paper as [16]
The cited source says what the claim attributes to it.
In the citing paper
“Since adrenal sensitivity appears to be differently affected in the morning and in the evening during sleep loss, 16”
From Effects of Insufficient Sleep on Pituitary–Adrenocortical Response to CRH Stimulation in Healthy Men (2017) · cites this paper as [16]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Abstract
“correlated with the individual amount of sleep loss (rSp = 0.63, P < .02)”
§ Results
“The reduction in TST from the 10-hours-in-bed to the 4-hours-in-bed condition was correlated with the increase in the overall daytime levels of ACTH (rSp = 0.64, P < .02)”
Citations
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The Functional and Clinical Significance of the 24-Hour Rhythm of Circulating Glucocorticoids
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“This pattern found to be different in chronic sleep restriction, with levels to be higher during evening,(Guyon et al. 2014), an increase in the nadir levels, a delay in the phase of the cortisol rhythm and a lower rate of decline (Rao et al. 2021).”
Metadata
- Authors
- Guyon, A., Balbo, M., Morselli, L. L., Tasali, E., Leproult, R., L'Hermite-Balériaux, M., Van Cauter, E., & Spiegel, K.
- Affiliations
- Lyon 1 Université (FR)
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo (IT)
- University of Chicago (US)
- Université Libre de Bruxelles (BE)
- Libre de Bruxelles, Brussels, 1050 Belgium and Faculté de Médecine (M.L.-B.), Université Libre de Bruxelles, Brussels, 1070 Belgium
- Sleep, Metabolism, and Health Center (L.L.M., E.T., R.L., E.V.C.), Department of Medicine, University of Chicago, Chicago, Illinois 60637
- Corresponding author
- Spiegel, K.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2014-08-01
- Volume
- 99
- Issue
- 8
- Pages
- 2861-2868
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC4121029
- OpenAlex
- W2102478373
- Cited by
- 127
- References
- 46
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 10 · 2023: 7 · 2022: 12 · 2021: 12 · 2020: 9 · 2019: 12 · 2018: 5 · 2017: 8 · 2016: 16 · 2015: 14 · 2014: 4
- FWCI
- 6.87
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- HAL (submittedVersion)
- Funders
- University of Chicago
- National Institutes of Health (UL1TR000430)
- National Institute on Aging (P01-AG11412., P01AG011412)
- National Institute of Diabetes and Digestive and Kidney Diseases (P60DK20595, P60DK020595)
- National Center for Research Resources (P41RR013642)
- NIH Clinical Center
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep restriction, sleep deprivation, hypothalamic-pituitary-adrenal axis, ACTH, cortisol, free cortisol, circadian rhythm, perceived stress, appetite, hunger, cardiometabolic risk, healthy men
- MeSH terms
- Adrenocorticotropic Hormone, Adult, Circadian Rhythm, Health, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Pituitary-Adrenal System, Sleep, Sleep Deprivation, Time Factors, Cross-Over Studies, Young Adult
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.
A language model drew the claims from the paper on 2026-10-09, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-09 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
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