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. 2021 Apr:17:8-14.
doi: 10.1016/j.coemr.2020.10.002. Epub 2020 Oct 24.

The Hypothalamic Pituitary Thyroid Axis and Sleep

Skand Shekhar  1   2 , Janet E Hall  2 , Joanna Klubo-Gwiezdzinska  3
Affiliations

The Hypothalamic Pituitary Thyroid Axis and Sleep

Skand Shekhar et al. Curr Opin Endocr Metab Res. 2021 Apr.

Abstract

Sleep has a bidirectional relationship with the hypothalamic-pituitary-thyroid (HPT) axis, and both these homeostatic processes are inter-dependent for robust physiological functioning. The quality and quantity of sleep influence the circadian pattern of TSH and thyroid hormone secretion. Short term sleep restriction significantly reduces the amplitude of nocturnal TSH secretion and may modulate active thyroid hormone secretion, likely through an increased sympathetic tone. Conversely, TSH and active thyroid hormone affect the quantity and architecture of sleep. For instance, low TSH values are permissive for slow wave sleep and maintenance of normal sleep architecture, while the hypo- or hyper-secretion of active thyroid hormones adversely affects the quality and quantity of sleep. Structural thyroid disorders may also be associated with an altered circadian clock - a phenomenon warranting further investigation. In this review, we aim to provide readers a comprehensive review on the associations between the HPT axis and sleep patterns.

Keywords: Hypothalamic pituitary thyroid axis; Sleep; TSH; circadian clock; thyroid hormones.

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Figures

Figure 1:
Figure 1:
Control of thyroid hormone secretion. Abbreviations- SCN: Suprachiasmatic Nucleus; PB: Pineal Body; TRH: thyrotropin releasing hormone; TSH: thyroid stimulating hormone.
Figure 2:
Figure 2:
The effect of acute sleep restriction on the diurnal variation thyroid stimulating hormone (TSH) and thyroid hormone. Disclaimer: This graph is largely derived from the work of Spiegel et al. and Van Cauter et al. (References 38 and 39) and is merely an abstraction of published reports and is not based on authors’ primary data.
See this image and copyright information in PMC

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