title: Total sleep deprivation and the thyroid axis: effects of sleep and waking activity.
abstract: BACKGROUND
  Circadian and sleep components modulate anterior pituitary release of thyrotropin (TSH), the chemical substance regulating the thyroid hormones, thyroxine (T4), and triiodothyronine (T3). The present study examined TSH, T4, and T3 concentrations across the wake-sleep boundary time (2300-0130 hours) before, during, and after a 64-h sleep deprivation paradigm. Additionally, adrenocorticotropic hormone (ACTH) and cortisol were measured as an index of hypothalamic-pituitary-adrenal axis activation. Activity levels and ratings of effort required to perform cognitive tasks were also incorporated to evaluate physical and cognitive load, respectively, across the study period. Assessing the combined effects of activity and sleep deprivation on thyroid hormone economy is relevant to the relationship of high physical and/or cognitive performance demands during sleep deprivation inherent in extended military operations and space exploration.
  
  
  METHODS
  There were 12 healthy subjects who were monitored during a 2-d baseline period, 3 d of total sleep deprivation, and 2 nights of recovery sleep. Serum samples were collected at 2300 hours and 0130 hours across the entire study period, and measured for TSH, T4, T3, and glucocorticoids.
  
  
  RESULTS
  Change scores evaluated at the wake-sleep boundary time demonstrated significant inhibitory effects of sleep on thyroid hormone measures. As expected, sleep deprivation was associated with elevated TSH. However, sleep deprivation also significantly increased circulating levels of T3 at 2300 hours and T4 concentration change scores (2300-0130 hours). Glucocorticoid levels did not track thyroid hormone changes. Physical activity remained constant while subjective ratings of effort to perform cognitive tasks increased significantly during sleep deprivation.
  
  
  CONCLUSIONS
  Compared to sleep deprivation studies under constant conditions reporting no change in peripheral T4 and T3 levels, the present study suggests activity level, including cognitive effort to perform, during total sleep deprivation may produce substantive changes in the thyroid axis.
authors.affiliation: Department of Psychiatry, University of Pennsylvania Medical School, Philadelphia 19104-6021, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Gary
authors.forename: A
authors.initials: A
authors.lastname: Winokur
authors.forename: S D
authors.initials: SD
authors.lastname: Douglas
authors.forename: S
authors.initials: S
authors.lastname: Kapoor
authors.forename: L
authors.initials: L
authors.lastname: Zaugg
authors.forename: D F
authors.initials: DF
authors.lastname: Dinges
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D008297:Male; D012892:Sleep Deprivation / Q000502:physiology*; D013961:Thyroid Gland / Q000502:physiology*; D013963:Thyroid Hormones / Q000097:blood*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D014851:Wakefulness / Q000502:physiology
chemical_list: D013963:Thyroid Hormones; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine