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HPA axis activity in patients with chronic insomnia: A systematic review and meta-analysis of case-control studies.
Dressle, Raphael J; Feige, Bernd; Spiegelhalder, Kai; Schmucker, Christine; Benz, Fee; Mey, Nina C; Riemann, Dieter.
Afiliación
  • Dressle RJ; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. Electronic address: raphael.dressle@uniklinik-freiburg.de.
  • Feige B; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
  • Spiegelhalder K; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
  • Schmucker C; Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
  • Benz F; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
  • Mey NC; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
  • Riemann D; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine University of Freiburg, Germany.
Sleep Med Rev ; 62: 101588, 2022 04.
Article en En | MEDLINE | ID: mdl-35091194
Insomnia is a highly prevalent disorder and a state of 24 h hyperarousal is considered as a key factor of this condition. Various physiological markers of hyperarousal have been investigated, including the activity of the HPA axis. However, these studies yielded heterogenous results. The aim of this study was to qualitatively and quantitatively evaluate whether there are differences in cortisol levels, the hormonal end product of the HPA axis, between patients with insomnia and good sleeper controls (GSC). The databases PubMed, Cinahl, PsycInfo, PsycArticles and Web of Science were searched for case-control studies comparing cortisol levels in patients with insomnia and GSC. Twenty studies (449 patients with insomnia, limited to ages 18-70 not taking any medications; 357 GSC) met the inclusion criteria. For each study, standardized mean differences (SMD) were calculated as a measure of effect size. Results suggest that patients with insomnia show moderately increased cortisol levels (SMD = 0.50, 95% CI: [0.21-0.80]). Higher effect sizes were found by including only studies using blood samples in the analysis (SMD = 0.67, 95% CI: [0.15-1.18]). Furthermore, a positive, but insignificant association was found between the extent of objective sleep loss in insomnia patients and group differences in cortisol levels.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos del Inicio y del Mantenimiento del Sueño Tipo de estudio: Observational_studies / Risk_factors_studies / Systematic_reviews Límite: Adolescent / Adult / Aged / Humans / Middle aged Idioma: En Revista: Sleep Med Rev Asunto de la revista: MEDICINA Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos del Inicio y del Mantenimiento del Sueño Tipo de estudio: Observational_studies / Risk_factors_studies / Systematic_reviews Límite: Adolescent / Adult / Aged / Humans / Middle aged Idioma: En Revista: Sleep Med Rev Asunto de la revista: MEDICINA Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido