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J Clin Endocrinol Metab. 2016 Nov;101(11):3968-3977. Epub 2016 Jul 12.

Sex Hormones and Sleep in Men and Women From the General Population: A Cross-Sectional Observational Study.

Author information

1
Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany.

Abstract

CONTEXT AND OBJECTIVES:

Associations between sex hormones and sleep habits originate mainly from small and selected patient-based samples. We examined data from a population-based sample with various sleep characteristics and the major part of sex hormones measured by mass spectrometry.

DESIGN, SETTING, AND PARTICIPANTS:

We used data from 204 men and 213 women of the cross-sectional Study of Health in Pomerania-TREND.

MAIN OUTCOME AND MEASURES:

Associations of total T (TT) and free T, androstenedione (ASD), estrone, estradiol (E2), dehydroepiandrosterone-sulphate, SHBG, and E2 to TT ratio with sleep measures (including total sleep time, sleep efficiency, wake after sleep onset, apnea-hypopnea index [AHI], Insomnia Severity Index, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index) were assessed by sex-specific multivariable regression models.

RESULTS:

In men, age-adjusted associations of TT (odds ratio 0.62; 95% confidence interval (CI) 0.46-0.83), free T, and SHBG with AHI were rendered nonsignificant after multivariable adjustment. In multivariable analyses, ASD was associated with Epworth Sleepiness Scale (β-coefficient per SD increase in ASD: -0.71; 95% CI: -1.18 to -0.25). In women, multivariable analyses showed positive associations of dehydroepiandrosterone-sulphate with wake after sleep onset (β-coefficient: .16; 95% CI 0.03-0.28) and of E2 and E2 to TT ratio with Epworth Sleepiness Scale. Additionally, free T and SHBG were associated with AHI in multivariable models among premenopausal women.

CONCLUSIONS:

The present cross-sectional, population-based study observed sex-specific associations of androgens, E2, and SHBG with sleep apnea and daytime sleepiness. However, multivariable-adjusted analyses confirmed the impact of body composition and health-related lifestyle on the association between sex hormones and sleep.

PMID:
27403929
DOI:
10.1210/jc.2016-1832
[Indexed for MEDLINE]

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