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Article: A community-based study on the association between insomnia and hypothalamic-pituitary-adrenal axis: Sex and pubertal influences

TitleA community-based study on the association between insomnia and hypothalamic-pituitary-adrenal axis: Sex and pubertal influences
Authors
Issue Date2014
Citation
Journal of Clinical Endocrinology and Metabolism, 2014, v. 99, n. 6, p. 2277-2287 How to Cite?
AbstractContext: The association between insomnia disorder and the hypothalamic-pituitary-adrenal (HPA) axis needs to be explored in both adults and adolescents. Objectives: Our objective was to investigate the associations of the HPA axis (via serial salivary cortisol) with insomnia disorder and subjective and objective sleep quality in a community-based study. Design and Setting: This was a community-based case-control family study. Participants: Participants included 205 adolescents (14.2 ± 2.8 years old, 51.7% females, and 57 with insomnia) and 244 adults (46.4 ± 4.1 years old, 52.8% females, and 69 with insomnia). Main Outcome Measures: Outcome measures included a diagnostic interview for assessment of insomnia disorder, 3-day actigraphy and sleep diary, and serial salivary cortisol measurement. Results: Adults with insomnia had a significantly greater cortisol awakening response (CAR) reference to increase (CARi) but a comparable CAR reference to ground and a comparable cortisol level during afternoon and evening when compared with noninsomniac adults. The association between insomnia disorder and larger CARi was also found in adolescents at late/post puberty but not in pre/early pubertal adolescents. There was an interaction effect between sex and insomnia disorderonCARi level with adult females having largerCARi than adult males.Amongsubjects with insomnia disorder, those with lower subjective sleep efficiency had higher cortisol levels in the late evening (10:00 PM) in both adults and adolescents. Conclusions: Our study suggests that a series of insomniac indices at both syndromal and symptomatic levels including clinical diagnosis and poor sleep quality are associated with dysfunction of theHPAaxis. The association between insomniaandincreasedCARi emerges at late puberty,and the sex difference in this association occurs in adulthood but not in adolescence. © 2014 by the Endocrine Society.
Persistent Identifierhttp://hdl.handle.net/10722/222161
ISSN
2015 Impact Factor: 5.531
2015 SCImago Journal Rankings: 2.940

 

DC FieldValueLanguage
dc.contributor.authorZhang, Jihui-
dc.contributor.authorLam, Siu Ping-
dc.contributor.authorLi, Shirley Xin-
dc.contributor.authorMa, Ronald C W-
dc.contributor.authorKong, Alice P S-
dc.contributor.authorChan, Michael H M-
dc.contributor.authorHo, Chung Shun-
dc.contributor.authorLi, Albert M.-
dc.contributor.authorWing, Yun Kwok-
dc.date.accessioned2015-12-21T06:49:06Z-
dc.date.available2015-12-21T06:49:06Z-
dc.date.issued2014-
dc.identifier.citationJournal of Clinical Endocrinology and Metabolism, 2014, v. 99, n. 6, p. 2277-2287-
dc.identifier.issn0021-972X-
dc.identifier.urihttp://hdl.handle.net/10722/222161-
dc.description.abstractContext: The association between insomnia disorder and the hypothalamic-pituitary-adrenal (HPA) axis needs to be explored in both adults and adolescents. Objectives: Our objective was to investigate the associations of the HPA axis (via serial salivary cortisol) with insomnia disorder and subjective and objective sleep quality in a community-based study. Design and Setting: This was a community-based case-control family study. Participants: Participants included 205 adolescents (14.2 ± 2.8 years old, 51.7% females, and 57 with insomnia) and 244 adults (46.4 ± 4.1 years old, 52.8% females, and 69 with insomnia). Main Outcome Measures: Outcome measures included a diagnostic interview for assessment of insomnia disorder, 3-day actigraphy and sleep diary, and serial salivary cortisol measurement. Results: Adults with insomnia had a significantly greater cortisol awakening response (CAR) reference to increase (CARi) but a comparable CAR reference to ground and a comparable cortisol level during afternoon and evening when compared with noninsomniac adults. The association between insomnia disorder and larger CARi was also found in adolescents at late/post puberty but not in pre/early pubertal adolescents. There was an interaction effect between sex and insomnia disorderonCARi level with adult females having largerCARi than adult males.Amongsubjects with insomnia disorder, those with lower subjective sleep efficiency had higher cortisol levels in the late evening (10:00 PM) in both adults and adolescents. Conclusions: Our study suggests that a series of insomniac indices at both syndromal and symptomatic levels including clinical diagnosis and poor sleep quality are associated with dysfunction of theHPAaxis. The association between insomniaandincreasedCARi emerges at late puberty,and the sex difference in this association occurs in adulthood but not in adolescence. © 2014 by the Endocrine Society.-
dc.languageeng-
dc.relation.ispartofJournal of Clinical Endocrinology and Metabolism-
dc.titleA community-based study on the association between insomnia and hypothalamic-pituitary-adrenal axis: Sex and pubertal influences-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1210/jc.2013-3728-
dc.identifier.pmid24617708-
dc.identifier.scopuseid_2-s2.0-84902341026-
dc.identifier.volume99-
dc.identifier.issue6-
dc.identifier.spage2277-
dc.identifier.epage2287-
dc.identifier.eissn1945-7197-

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