hypothalamic–pituitary–gonadal activity in paradoxical and psychophysiological insomnia

Background: although insomnia is a sex‑dimorphic disorder, there is limited knowledge about theassociation between sex hormones and insomnia. in the present study, the level of hypothalamus–pituitary–gonadal (hpg) axis activity was investigated in patients with insomnia by measuring serumlevels of luteinizing hormone (lh), follicle stimulating hormone (fsh), 17α‑hydroxyprogesterone,testosterone, progesterone, estradiol, dehydroepiandrosterone sulfate, and sex hormone‑binding globulin.methods: numbers of 19 patients; including 13 females (68.40%) with paradox insomnia (32–53 years; 43.20 ± 6.40) and 17 patients; including 8 females (47.05%) with psychophysiologicalinsomnia (14–62 years; 38.40 ± 16.30) were recruited. seventeen aged‑matched normal sleeperconsisted of 13 males (26–59 years; 40.70 ± 10) consisted of 13 males (76.50%) were also recruited ascontrol group. insomnia was diagnosed by a sleep clinician according to the international classificationof sleep disorders‑second edition criteria and an overnight polysomnography (psg). a volume of 5ml of venous blood samples were collected, prepared, and stored at 8 am under standard condition.serum levels of hormones were measured using enzyme‑linked immunosorbent assay kits. data wereanalyzed by chi‑square and ancova. the associations between psg and biochemical parameterswere evaluated using multiple linear regression analysis. results: there were no significant differencesin all biochemical analyses between two insomnia subgroups (paradoxical and psychophysiologicalinsomnia) and normal sleepers. testosterone was positively related to maximum pulse transittime (ptt). moreover, both lh and fsh were positively related to wake index and diastolic bloodpressure. conclusion: although there were no significant differences in all hpg’s hormones betweengroups, both lh and fsh were associated with wake index and diastolic blood pressure. moreover,testosterone was positively related to ptt.