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Insomniacs
Have Hyperactive Stress System
NEW
YORK (Reuters Health) - Scientists have found increased blood
levels of stress hormones in people with chronic insomnia, suggesting
that these individuals suffer from sustained, round-the-clock
activation of the body's system for responding to stress.
For this reason,
the researchers suggest, doctors who treat insomnia should go
beyond improving the quality or quantity of their patients' sleep
and seek to reduce this hyperarousal, which is a risk factor for
both psychiatric and medical illness.
Dr. Alexandros
N. Vgontzas, of Pennsylvania State University College of Medicine
in Hershey, and associates monitored the sleep of 11 patients
with insomnia and 13 people without sleep disturbances (the ``control''
group). Blood was collected every 30 minutes for 24 hours, and
levels of stress hormones--adrenocorticotropic hormone (ACTH)
and cortisol--were monitored.
Average levels
of both hormones were significantly higher in the insomniacs than
in the control group, the researchers report in the August issue
of The Journal of Clinical Endocrinology and Metabolism.
``We found
that the insomniacs with the highest degree of sleep disturbance
secreted the highest amount of cortisol, particularly in the evening
and nighttime hours,'' Vgontzas said in a prepared statement.
``This means that insomniacs are experiencing hormonal changes
in their bodies, which prevents them from sleeping.''
Vgontzas and
colleagues propose that the physical mechanism of chronic insomnia
differs from that of sleep loss, with chronic insomnia being a
disorder of hyperarousal present throughout the 24-hour sleep/wake
cycle. Increased production of stress hormones is likely to lead
not only to depression, but also to high blood pressure, obesity
and the bone-thinning disease osteoporosis, the researchers suggest.
``This information
could help doctors who are treating insomniacs refocus their therapeutic
goals,'' Vgontzas said in the statement. ``Instead of aiming to
simply improve nighttime sleep, doctors may now work to decrease
the levels of physiologic arousal.''
Toward that
end, medications that downregulate the activity of the stress
system, such as antidepressants, may be of more help to patients
than hypnotic drugs, the investigators remark.
SOURCE:
Journal of Clinical Endocrinology & Metabolism 2001;86:3787-3794.
Reference
Source 89
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