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Lok R, Qian J, Chellappa SL. Sex differences in sleep, circadian rhythms, and metabolism: Implications for precision medicine. Sleep Med Rev 2024; 75:101926. [PMID: 38564856 DOI: 10.1016/j.smrv.2024.101926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/16/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
The number of individuals experiencing sleep loss has exponentially risen over the past decades. Extrapolation of laboratory findings to the real world suggests that females are more affected by extended wakefulness and circadian misalignment than males are. Therefore, long-term effects such as sleep and metabolic disorders are likely to be more prevalent in females than in males. Despite emerging evidence for sex differences in key aspects of sleep-wake and circadian regulation, much remains unknown, as females are often underrepresented in sleep and circadian research. This narrative review aims at highlighting 1) how sex differences systematically impinge on the sleep-wake and circadian regulation in humans, 2) how sex differences in sleep and circadian factors modulate metabolic control, and 3) the relevance of these differences for precision medicine. Ultimately, the findings justify factoring in sex differences when optimizing individually targeted sleep and circadian interventions in humans.
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Affiliation(s)
- Renske Lok
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
| | - Jingyi Qian
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Females's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Sarah L Chellappa
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom.
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Haase L, Vehlen A, Strojny J, Domes G. Effects of menstrual cycle phase and ovulation on the salivary cortisol awakening response. Psychoneuroendocrinology 2024; 160:106669. [PMID: 37988874 DOI: 10.1016/j.psyneuen.2023.106669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 11/23/2023]
Abstract
The cortisol awakening response (CAR) is influenced by several state and trait variables, one of which might be the menstrual cycle in women. Previous results suggested that the CAR is enhanced around ovulation, which is why it has been recommended to avoid sampling during the ovulatory phase. In two separate studies, we aimed to replicate previous findings that reported the CAR's modulation across the menstrual cycle, especially during ovulation. In Study 1, a group of 27 healthy naturally cycling women collected saliva at 0, 30, 45, and 60 min post-awakening on two days during their follicular, ovulatory, and luteal phases in a repeated measures design. In Study 2, CAR samples were collected from 30 healthy naturally cycling women on seven consecutive days around the expected ovulation. To increase reliability of CAR measurements, participants' compliance of saliva sampling times was monitored, ovarian steroids (estradiol and progesterone) were collected, and ovulation was confirmed with specific test kits. Contrary to our expectations, we detected no differences in the CAR over the menstrual cycle, and no significant association with variations in estradiol and progesterone. In addition, we excluded confounding effects such as compliance and validated the cycle phase. These results suggest that the CAR is largely robust against hormonal variations across the menstrual cycle, including the mid-cycle phase around ovulation. However, further research is needed to understand the potential ovarian steroid-induced modulation of HPA axis functioning and the menstrual cycle's effects on salivary cortisol levels in psychobiological studies.
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Affiliation(s)
- Lisa Haase
- Biological and Clinical Psychology, Department of Psychology, University of Trier, Trier, Germany; Institute for Cognitive and Affective Neuroscience, University of Trier, Trier, Germany.
| | - Antonia Vehlen
- Biological and Clinical Psychology, Department of Psychology, University of Trier, Trier, Germany
| | - Julia Strojny
- Biological and Clinical Psychology, Department of Psychology, University of Trier, Trier, Germany
| | - Gregor Domes
- Biological and Clinical Psychology, Department of Psychology, University of Trier, Trier, Germany; Institute for Cognitive and Affective Neuroscience, University of Trier, Trier, Germany.
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Garre-Morata L, de Haro T, Villén RG, Fernández-López ML, Escames G, Molina-Carballo A, Acuña-Castroviejo D. Changes in Cortisol and in Oxidative/Nitrosative Stress Indicators after ADHD Treatment. Antioxidants (Basel) 2024; 13:92. [PMID: 38247516 PMCID: PMC10812591 DOI: 10.3390/antiox13010092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
Although ADHD is one of the most prevalent diseases during childhood, we still do not know its precise origin; oxidative/nitrosative stress and the hypothalamic-pituitary-adrenal axis are suggested contributors. Methylphenidate, among others, is the main drug used in ADHD patients, but its effects on relevant markers and structures remain unclear. This study, involving 59 patients diagnosed with ADHD according to DSM-5 criteria, aimed to assess changes in cortisol levels (using cortisol awakening response, CAR) and oxidative/nitrosative status with the treatment. Blood samples before and 3 months after treatment with methylphenidate were used to measure oxidative and inflammatory markers, as well as the endogenous antioxidant activity, while saliva samples tracked cortisol awakening response (CAR). The results showed a treatment-related improvement in the redox profile, with the reduction in advanced oxidation protein products (AOPP), lipid peroxidation (LPO), and nitrite plus nitrate (NOx) levels, and the increase in the enzymatic activities of glutathione reductase (GRd) and catalase (CAT). Moreover, the area under the curve (AUC) of CAR increased significantly, indicating increased reactivity of the HPA axis. These results support, for the first time, the involvement of the endogenous antioxidant system in the pathophysiology of ADHD.
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Affiliation(s)
- Laura Garre-Morata
- UGC of Laboratorios Clínicos, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain; (L.G.-M.); (T.d.H.)
| | - Tomás de Haro
- UGC of Laboratorios Clínicos, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain; (L.G.-M.); (T.d.H.)
- Ibs.Granada, 18016 Granada, Spain; (M.L.F.-L.); (G.E.)
| | | | - María Luisa Fernández-López
- Ibs.Granada, 18016 Granada, Spain; (M.L.F.-L.); (G.E.)
- UGC of Pediatrics, San Cecilio University Hospital, 18016 Granada, Spain;
| | - Germaine Escames
- Ibs.Granada, 18016 Granada, Spain; (M.L.F.-L.); (G.E.)
- Ibs.CIBERfes, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable, 18016 Granada, Spain
- Centro de Investigación Biomédica, Departamento de Fisiología, Facultad de Medicina, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, 18016 Granada, Spain
| | - Antonio Molina-Carballo
- Ibs.Granada, 18016 Granada, Spain; (M.L.F.-L.); (G.E.)
- UGC of Pediatrics, San Cecilio University Hospital, 18016 Granada, Spain;
- Department of Pediatrics, Medicine Faculty, University of Granada, 18071 Granada, Spain
| | - Darío Acuña-Castroviejo
- UGC of Laboratorios Clínicos, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain; (L.G.-M.); (T.d.H.)
- Ibs.Granada, 18016 Granada, Spain; (M.L.F.-L.); (G.E.)
- Ibs.CIBERfes, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable, 18016 Granada, Spain
- Centro de Investigación Biomédica, Departamento de Fisiología, Facultad de Medicina, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, 18016 Granada, Spain
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Kayacan Y, Makaracı Y, Ucar C, Amonette WE, Yıldız S. Heart Rate Variability and Cortisol Levels Before and After a Brief Anaerobic Exercise in Handball Players. J Strength Cond Res 2023; 37:1479-1485. [PMID: 36727970 DOI: 10.1519/jsc.0000000000004411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT Kayacan, Y, Makaracı, Y, Ucar, C, Amonette, WE, and Yıldız, S. Heart rate variability and cortisol levels before and after a brief anaerobic exercise in handball players. J Strength Cond Res 37(7): 1479-1485, 2023-Evaluating stress in athletes is important for monitoring overall physiologic load and is a core practice for sport performance teams. This study examined relationships between 2 metrics of training stress, heart rate variability (HRV) and cortisol, before and after intense anaerobic power testing. Electrocardiogram recordings and saliva samples were collected before and immediately after a Wingate anaerobic power test (WAnT-30) from professional handball players ( n = 20) and sedentary controls ( n = 18). Between-group differences and correlations were computed to assess study hypotheses. No differences were observed in HRV frequency-dependent parameters between groups, but in athletes, Min. R-R ( p < 0.01) and Avg.R-R ( p = 0.03) before WAnT-30 and the percentage of successive normal cardiac beat intervals greater than 50 milliseconds (i.e., pNN50; p = 0.03) after WAnT-30 were elevated. A high positive correlation was detected between the pretest and post-test cortisol levels in athletes ( p = 0.0001; r = 0.87) but not in sedentary individuals. No correlations were observed between the cortisol levels and WAnT-30 power parameters in either group. Relationships were evident in the standard deviation of RR intervals ( p = 0.02, r = -0.53), square root of the mean squared difference of successive RR intervals ( p = 0.043, r = -0.46), very low frequency ( p = 0.032; r = -0.480), high-frequency ( p = 0.02; r = -0.52) variables, and pretesting cortisol in athletes. These findings suggest that HRV analysis is a valuable tool for examining cardiovascular regulation, independent of cortisol; the data may provide valuable information for performance teams in evaluating acute stress.
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Affiliation(s)
- Yıldırım Kayacan
- Yasar Dogu Faculty of Sports Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Yücel Makaracı
- Faculty of Sport Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Cihat Ucar
- Faculty of Medicine, Department of Physiology, Adıyaman University, Adıyaman, Turkey
| | - William E Amonette
- Health and Human Performance Institute, University of Houston-Clear Lake, Houston, Texas; and
| | - Sedat Yıldız
- Faculty of Medicine, Department of Physiology, Inönü University, Malatya, Turkey
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Uçar C, Bülbül M, Yıldız S. Cesarean delivery is associated with suppressed activities of the stress axes. Stress 2022; 25:67-73. [PMID: 34931594 DOI: 10.1080/10253890.2021.2015318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Maternal pre- and post-delivery stress levels might be different for vaginal or cesarean deliveries. This study aimed to investigate the effects of type of delivery (vaginal or cesarean) and time of delivery (pre- and post-delivery) on the stress axes of the body, namely the hypothalamic-pituitary adrenal axis (HPA) and autonomic nervous system (ANS).Ninety-one pregnant women were volunteered to participate this prospective study. In these women, pre- and post-delivery HPA and ANS activities were measured noninvasively by salivary cortisol and heart rate variability (HRV), respectively. HRV was measured by 5-min electrocardiogram recording and time- and frequency-domain parameters were computed.Salivary cortisol concentration and HRV parameters were higher in women having vaginal delivery than those having cesarean delivery (p < 0.05). Cortisol levels did not differ between pre- and post-delivery (p > 0.05) but the time-domain parameters of HRV decreased post-delivery (p < 0.05). No interactions were observed between the types and times of delivery (p > 0.05).HPA and ANS axes had different activity patterns throughout the delivery process and they were higher during vaginal delivery, suggesting that they are integral parts of normal birth process and that cesarean delivery perturbs the activity of both axes.
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Affiliation(s)
- Cihat Uçar
- Department of Physiology, Faculty of Medicine, University of Adıyaman, Adıyaman, Turkey
| | - Mehmet Bülbül
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Adiyaman, Adiyaman, Turkey
| | - Sedat Yıldız
- Department of Physiology, Faculty of Medicine, University of Inonu, Malatya, Turkey
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