How Does Human Growth Hormone Deficiency Impact Sleeping Habits: A Clinical Study
Researchers have long been aware that HGH Deficiency is strongly correlated with an increased incidence of sleeping problems, and in recent years, more time and effort have gone into exploring that correlation.
How Were Patients Selected for this HGH Sleep Study?
One study, published in 2010, analyzed thirty patients with Abnormally Low Growth Hormone Levels from four different University medical centers: the University of Pisa, Italy, the University of Liege in Belgium, the Free University of Brussels, and the University of Chicago. Patients were diagnosed with Human Growth Hormone Deficiency using a method known as the Insulin Tolerance Test. Patients were selected for this study if they showed less than three micrograms per liter after drinking Glucose Solution. Twenty-four of the patients suffered from Adult-Onset Hypopituitarism, while six were diagnosed early in life with Childhood-Onset Hypopituitarism.
Patients that were selected for study had not taken Bio-Identical HGH Injections for a minimum of six months before they were selected, and some participants had never used Bio-Identical Human Growth Hormone Injections. Subjects were screened for a number of conditions, and were turned away if they showed any signs of Diabetes, Hyperprolactinemia, Psychiatric/Neurological Disease, chronic infection, heart problems, kidney problems, liver disease, or drug/alcohol abuse.
Also, patients that had traveled three time zones or more in the previous two weeks were excluded, as were people that were shift workers in the prior three months. Finally, participants had to be off of sleeping medications for a minimum of 90 days.
Adult-Onset HGH Deficiency Causes
The source of Hypogonadism varied from patient to patient. In twelve of the thirty patients, Adult-Onset Hypopituitarism was the result of a pituitary issue that did not involve other parts of the endocrine system. Ten patients had their pituitary removed via surgery. One patient experienced the death of a pituitary tumor which suppressed HGH Levels, and one patient suffered from the same issue, but from the stalk of the pituitary. None of these patients suffered from Diabetes Insipidus.
The second group of patients had pituitary issues that could have been partially the result of hypothalamic insufficiency. Two patients had a tumor removed from the pituitary and suffered from Diabetes Insipidus. One patient received radiation therapy to remove a pituitary tumor. Two patients experienced HGH Deficiency as a result of Craniopharyngioma. One patient had a pituitary tumor break down while also suffering from Diabetes Insipidus. There were two patients that had lesions both of the hypothalamus and the pituitary, resulting from histiocytosis and neurosarcoidosis, respectively.
Childhood-Onset HGH Deficiency Causes
In the Childhood-Onset Hypopituitarism group, six of the ten patients experienced their deficiency as a result of a known genetic predisposition to HGH Deficiency. One patient suffered from Hypothalamic Insufficiency that led to HGH Deficiency. Three others suffered from Hypopituitarism resulting from the appearance or removal of tumors from the Pineal Gland, the Olfactory Duct, and a Brain Tumor, respectively. Finally, the tenth participant suffered from HGH Deficiency resulting from Brain Thrombosis.
More HGH Patient Information
Among the thirty patients, 28 of them had received Bio-Identical Hormone Deficiency Treatment in the past for their Pituitary Insufficiency. There were 24 male patients and 6 female patients in the study. Each female HGH Deficiency subject was taking Estrogen Replacement Therapy, with 4 of those 6 taking progesterone as well.
Sixteen of the patients were simultaneously suffering from Testosterone Deficiency, and were either replacing their Testosterone with Intramuscular Testosterone Injections, or Topical Testosterone Products.
Twenty-one patients were taking Thyroxine for Thyroid Deficiency and twenty-four were taking cortisone acetate or hydrocortisone for adrenal hormone deficiency. Finally, seven patients were taking desmopressin.
HGH Deficiency: Experimental vs. Control
Every patient in this Hypopituitarism Sleep Study had their own personal control with normal HGH Levels. Experimental Group Patients averaged around 72 micrograms per deciliter, whereas control patients had an average of 194 micrograms per deciliter. All experimental patients had normal levels of potassium, sodium, and glucose. Overall, patients had Thyroxine Levels which averaged 86% of normal.
Each patient was matched with a control based upon Body Mass Index, Age, and Gender. The results of this study indicate that Human Growth Hormone Deficiency is strongly associated with daytime fatigue, inhibited sleep quality, and too much high-intensity Slow Wave Sleep. Strangely enough, this increased level of Slow Wave Sleep is not normally associated with most sleeping disorders, which are the result of inhibited Slow Wave Sleep.
There are a number of mechanisms by which this abnormal sleeping condition could lead to issues with sleep health and quality. There is evidence that Growth Hormone-Releasing Hormone enhances Delta Activity, because in healthy brains, HGH and IGF-1 serve as a negative feedback mechanism to limit Human Growth Hormone Production. There is animal research which supports this theory.
How Did HGH Deficiency Effect the Sleeping Patterns of Younger Patients?
Researchers also hypothesize that the hormone imbalance caused by the overproduction of Growth Hormone-Releasing Hormone could cause the body to continue to release signals for Slow Wave Sleep even while awake, which could lead to issues with daytime tiredness. This is especially pronounced among the youngest patients, as those with elevated levels of Slow Wave Sleep were more tired during the day than their counterparts. Among the thirty participants, exhaustion was the single complaint most reported in Self-Reported Quality of Life Scales.
How Did HGH Deficiency Effect the Sleep of Older Patients?
Among older Hypopituitarism patients, the most significant issue appeared to be a lack of sufficient REM Sleep, which is strongly correlated with Human Growth Hormone Deficiency. Lack of REM-Sleep is associated with a number of medical issues, including issues with memory. In this study, older patients with Human Growth Hormone Deficiency were more likely than their control counterparts to suffer from memory issues. As the body of research continues to grow, it becomes increasingly clear that memory is strongly correlated with sufficient REM-Sleep in adult patients.
Another issue that Older Adult Hypopituitarism Patients experienced was that they slept less than their control counterparts, and also slept less soundly and experienced a higher level of sleep fragmentation. It is true that older men and women experience less REM sleep as they grow older, as well as shorter sleep, and more frequent rousing from sleep, but experimental patients experienced these sleep issues at a rate higher than their control peers, and HGH Deficiency appears to be a powerful mechanism which inhibits healthy sleep among these patients.
Older Adult HGH Deficiency patients simultaneously experienced Slow Wave Sleep of high intensity and long duration earlier in the sleep cycle, and had more issues staying asleep later in the sleep cycle. This is a strange issue, because enhanced Slow Wave Sleep is usually correlated with longer, steadier sleep.
Pituitary Insufficiency Vs. Combination Hypothalamic-Pituitary Insufficiency
So, for patients that only experienced pituitary issues with no hormone imbalance resulting from hypothalamic insufficiency, Slow Wave Sleep was longer, but didn't provide sleep benefits for other reasons. This was not the case for patients that were suffering from Hypothalamic issues in addition to Pituitary Insufficiency. Patients that had diminished GH-RH response had issues with Non-REM Sleep, not reaching a sufficient depth of sleep for optimal health. There is significant evidence from other studies that shows that GH-RH Deficiency is associated with an inability to sleep deeply.
For participants that were suffering from Pituitary issues in which Hypothalamic Insufficiency was not ruled out, the results were a mix between the two classes of Hormone Deficiency.
How Did this HGH Sleep Study Compare to Previous Studies?
Interestingly enough, the results of this study were different from another study released twenty years previously, which studied patients with Isolated Growth Hormone Deficiency. There are a number of reasons for this, however. In the older study, participants were controlled on age and sex, but not with regard to Body Mass Index.
There were other aspects which were insufficiently controlled as well. Patients were not monitored for how long they slept, nor when they went to sleep. The earlier study also allowed for naps, and patients were not limited in their activity in the previous study.
In this earlier study, patients slept much longer, ranging from 7:45 of sleep to 11:44 among the eight patients. Increased need for naps and longer periods of sleep are generally associated with fitful sleep which is not sufficiently deep. Because of these various differences, the results in the newer study were different.
Another older study found no significant difference between patients with Adult-Onset Human Growth Hormone Deficiency and otherwise healthy patients, but the patients were not matched to their controls with regard to sleeping habits, age, gender, and other characteristics, which led the study to be unable to register sleep differences between HGH Deficiency patients and healthy patients.
Could Other Hormone Deficiencies Have Impacted Sleep Quality?
Almost all of the patients in this Growth Hormone Deficiency Study received some form of Hormone Replacement Treatment, such as Estrogen, Testosterone, Thyroxine, Cortisone, or Hydrocortisone, although none of the patients were receiving Growth Hormone Therapy.
There is no way to rule out that any of these treatments or other underlying hormone deficiencies could have an impact on their sleeping patterns and habits as well. In spite of this, the fact that older patients experienced greater issues with sleep than their younger counterparts does provide strong evidence that HGH / GH-RH Deficiency do have a powerful impact on sleep quality.
HGH Study Conclusion
Based on the results of this study, there is strong evidence that Human Growth Hormone Deficiency impacts health in a number of ways related to sleep, including increased feelings of exhaustion and sleepiness during the day, caused by inhibited sleep quality during the night.
The mechanism by which Human Growth Hormone Deficiency impacts sleep quality depends on multiple variables, and the age of the patient and the cause of HGH Deficiency both seem to be very important signifiers.
How Does This Study Relate to Age-Related Hypopituitarism and Somatopause?
It's important to note that this study almost universally involved patients with damaged or otherwise non-functional Somatotrophs. Age-Related HGH Deficiency is most commonly the result of an underlying GH-RH Deficiency.
Patients in this study that were unable to produce sufficient GH-RH experienced issues with their ability to achieve deep sleep, which is in line with the experiences of patients that suffer from HGH Deficiency resulting from the aging process.