title: Reciprocal interactions between the GH axis and sleep.
abstract: For more than 30 years, growth hormone (GH) has been observed to be preferentially secreted during deep, slow-wave sleep (SWS). However, the mechanisms that underlie this robust relationship that links anabolic processes in the body with behavioral rest and decreased cerebral metabolism remain to be elucidated. Current evidence indicates that GH secretion during the beginning of sleep appears to be primarily regulated by GH-releasing hormone (GHRH) stimulation occurring during a period of relative somatostatin withdrawal, which also is associated with elevated levels of circulating ghrelin. Apparently, two populations of GHRH neurons need to be simultaneously active to stimulate, in a coordinated fashion, SWS and pituitary GH release. Pharmacological interventions that are capable of increasing the duration and/or the intensity of SWS such as oral administration of gamma-hydroxybutyrate (GHB), also increase the rate of GH release. Because the normal negative feedback exerted by GH on central GHRH is inoperative in patients with GH deficiency, it is possible that the decreased energy levels and fatigue often reported by GH-deficient adults partly reflect an alteration in sleep-wake regulation. Preliminary data from a sleep study of adults with GH deficiency using wrist actigraphy for 6 nights at home and polysomnography in the laboratory indeed show decreased total sleep time and increased sleep fragmentation in GH-deficient patients as compared with normal controls.
authors.affiliation: Department of Medicine, MC 1027, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA. evcauter@medicine.bsd.uchicago.edu
authors.forename: Eve
authors.initials: E
authors.lastname: Van Cauter
authors.forename: Federica
authors.initials: F
authors.lastname: Latta
authors.forename: Arlet
authors.initials: A
authors.lastname: Nedeltcheva
authors.forename: Karine
authors.initials: K
authors.lastname: Spiegel
authors.forename: Rachel
authors.initials: R
authors.lastname: Leproult
authors.forename: Claire
authors.initials: C
authors.lastname: Vandenbril
authors.forename: Roy
authors.initials: R
authors.lastname: Weiss
authors.forename: Jean
authors.initials: J
authors.lastname: Mockel
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Legros
authors.forename: Georges
authors.initials: G
authors.lastname: Copinschi
mesh_terms: D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency / Q000378:metabolism*; D006801:Humans; D010902:Pituitary Gland / Q000378:metabolism; D011788:Quality of Life; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000523:psychology; D014851:Wakefulness
chemical_list: D019382:Human Growth Hormone