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1- Sleep Disorder Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
2- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

There are controversial reports about association between sleep and hypothalamic–pituitary–adrenal (HPA) activity. Studies have reported the influence of insomnia on HPA hormones. However, they usually ignored the heterogeneity of insomnia symptoms, so subtypes of the disorder have not been considered in the reports. The aim of the present study was to investigate the final and intermediate products of HPA system among a group of psychophysiological and paradoxical insomniac patients in comparison to a group of normal sleepers. We investigated the awakening serum level of adrenocorticotropic hormone (ACTH) and cortisol after one night polysomnography (PSG) in 17 subjects with psychophysiological insomnia, 19 subjects with paradoxical insomnia and 17 subjects with normal sleep profile.  Groups were matched for age and body mass index (BMI). Serum levels of ACTH and cortisol were measured by enzyme-linked immunosorbent assay (ELISA) method. Although, a tendency toward elevation of both ACTH and cortisol was observed among patients with paradoxical insomnia compared to both control and psychophysiological insomnia, but the results were not significant comparing three groups. According to regression analysis, higher level of ACTH was significantly predicted by higher NREM arousality and pulse transit time (PTT). These findings could suggest the personality traits hypothesis for paradoxical insomnia. Both cortical and subcortical arousality could lead to more HPA activity and higher ACTH level. Further studies are recommended to confirm the hypothesis.  

Type of Study: Original | Subject: Cognitive Neuroscience
Received: 2017/07/11 | Accepted: 2018/02/25 | Published: 2018/05/13

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