Effects of Sleep Fragmentation and Estradiol Decline on Cortisol in a Human Experimental Model of Menopause
Authors' conclusion
Estradiol suppression and modifiable menopause-related sleep fragmentation both independently perturb HPA axis activity. Sleep fragmentation, commonly seen in menopausal women, may disrupt the HPA axis, which in turn may lead to adverse health effects as women age.
Study context
- Population
- Healthy young premenopausal women, academic medical center22 completed, 14 repeated
- Comparison
- Sleep fragmentation vs unfragmented sleep; hypoestrogenized vs estrogenized state
- Hypoestrogenizedn = 14
- Estrogenizedn = 22reference
- Outcome
- Serum bedtime cortisol levels and cortisol awakening response (CAR)
Methodological detailsinpatient, experimental sleep fragmentation, GnRH agonist-induced estradiol suppression
- Inpatient
- Experimental sleep fragmentation
- GnRH agonist-induced estradiol suppression
Main finding
As reported in the abstract
Bedtime cortisol increased after sleep fragmentation vs unfragmented sleep (P = .03)
27%
Cortisol awakening response (CAR) decreased after sleep fragmentation vs unfragmented sleep (P = .01)
57%
Bedtime cortisol lower in hypoestrogenized vs estrogenized state (P = .02)
22%
Further findings
Polysomnographic wake after sleep-onset (WASO) and cortisol
- WASO positively associated with bedtime cortisol (P = .047)
- WASO negatively associated with CAR (P < .01)
Original publication
Effects of Sleep Fragmentation and Estradiol Decline on Cortisol in a Human Experimental Model of Menopause. J Clin Endocrinol Metab. Published 19 May 2023. doi:10.
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