ArticleThe Journal of clinical endocrinology and metabolism2023
Effects of Sleep Fragmentation and Estradiol Decline on Cortisol in a Human Experimental Model of Menopause.
Article in The Journal of clinical endocrinology and metabolism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Efficacy of hormone therapy and phytoestrogens on the psychological symptoms of menopausal women: a systematic review, meta-analysis, and trial sequential analysis.Frontiers in medicine · 2026Pooled it
- Impact of sleep restriction on biomarkers of thyroid function: Two pooled randomized trials.Sleep medicine · 2024Trial
- Ovariectomy, but not moderate intermittent hypoxia, promotes respiratory instability and risk of obesity in adult female rats.Experimental physiology · 2026Article
- Progressive hypothalamic neuroinflammation in ovariectomized mice parallels aging-related transcriptomic changes in the female human hypothalamus.JCI insight · 2026Article
- Are psychosocial factors and menopause symptoms related to hair cortisol concentrations among midlife Latinas? Results from theComprehensive psychoneuroendocrinology · 2026Article
- Distinct From the Adult Paradigm: Re-Evaluate the Pathophysiological and Therapeutic Framework in Children and Adolescent Hyperlipidaemia.Current obesity reports · 2026Review
- Adverse Cardiometabolic Impacts of Sleep Fragmentation and Estradiol Suppression: An Experimental Model of Menopause.The Journal of clinical endocrinology and metabolism · 2026Article
- The association between heart rate variability and inflammatory markers in first-episode depressed patients with different sleep quality.BMC psychiatry · 2025Article
- Association between gastrointestinal symptoms and insomnia among healthcare workers: a cross-sectional study.Scientific reports · 2025Article
- Natural strategies to optimize estrogen levels in aging women: mini review.Frontiers in aging · 2025Review
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- Impact of sleep on gastrointestinal cancer.World journal of clinical oncology · 2024Article
- Exploratory metabolomic analysis for characterizing the metabolic profile of the urinary bladder under estrogen deprivation.Frontiers in endocrinology · 2024Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
contextPerturbations to the hypothalamic-pituitary-adrenal (HPA) axis have been hypothesized to increase postmenopausal cardiometabolic risk. Although sleep disturbance, a known risk factor for cardiometabolic disease, is prevalent during the menopause transition, it is unknown whether menopause-related sleep disturbance and estradiol decline disturb the HPA axis.
objectiveWe examined the effect of experimental fragmentation of sleep and suppression of estradiol as a model of menopause on cortisol levels in healthy young women.
methodsTwenty-two women completed a 5-night inpatient study during the mid-to-late follicular phase (estrogenized). A subset (n = 14) repeated the protocol after gonadotropin-releasing hormone agonist-induced estradiol suppression. Each inpatient study included 2 unfragmented sleep nights followed by 3 experimental sleep fragmentation nights. This study took place with premenopausal women at an academic medical center. Interventions included sleep fragmentation and pharmacological hypoestrogenism, and main outcome measures were serum bedtime cortisol levels and cortisol awakening response (CAR).
resultsBedtime cortisol increased 27% (P = .03) and CAR decreased 57% (P = .01) following sleep fragmentation compared to unfragmented sleep. Polysomnographic-derived wake after sleep-onset (WASO) was positively associated with bedtime cortisol levels (P = .047) and negatively associated with CAR (P < .01). Bedtime cortisol levels were 22% lower in the hypoestrogenized state compared to the estrogenized state (P = .02), while CAR was similar in both estradiol conditions (P = .38).
conclusionEstradiol suppression and modifiable menopause-related sleep fragmentation both independently perturb HPA axis activity. Sleep fragmentation, commonly seen in menopausal women, may disrupt the HPA axis, which in turn may lead to adverse health effects as women age.
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Registered trials
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