Sleep appears to have an inhibiting effect on the Hypothalamic-Pituitary -Adrenal (HPA) Axis while dysregulation of the HPA axis is present in several sleep disorders. Patients with chronic insomnia show evidence of increased hypothalamic CRH release, while patients with primary hypersomnia or sleep apnea seem to have dysregulation of the HPA axis. This study will assess the baseline function of the HPA axis in patients with sleep disorders and normal controls. Our specific objectives are: to assess the circadian pattern of ACTH, cortisol and catecholamine secretion in subjects with sleep disorders and age, sex and weight-matched controls; and to assess the effects of HPA dysregulation in GH secretion. We believe that patients with sleep disorders associated with hyperarousal e.g. insomnia or significant sleep disruption i.e. apnea will be associated with an activation of the HPA axis and suppression of the GH axis while patients with disorders associated with hypoarousal i.e. idiopathic hypersomnia will be associated with hypofunctioning of the HPA axis.
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