Physiology of growth hormone secretion during sleep☆,☆☆,★,★★

https://doi.org/10.1016/S0022-3476(96)70008-2Get rights and content

Abstract

The temporal relation between the first few hours of sleep and the secretion of growth hormone (GH), which is present in normal persons of both sexes from early childhood until late adulthood, is reviewed. In adults the most reproducible pulse of GH secretion occurs shortly after the onset of sleep in association with the first phase of slow-wave sleep (SWS) (stages III and IV). In men approximately 70% of the GH pulses during sleep coincide with SWS, and the amount of GH secreted during these pulses correlates with the concurrent amount of SWS. Sleep-related secretion of GH appears to be primarily dependent on the release of growth hormone-releasing hormone. Rodent and human studies have shown that growth hormone-releasing hormone injections decrease wakefulness and increase SWS. During the fourth decade of life (ages 30 to 40 years) the total amount of GH secreted over a 24-hour span decreases by two- to threefold. Similarly, the amount of SWS decreases dramatically over the same narrow age range. Because the sleep-onset GH pulse is often the major secretory output in adults, age-related decrements in sleep-related GH secretion likely play a major role in the hyposomatotropism of senescence. (J PEDIATR 1996;128:S32-7)

Section snippets

PUTATIVE MECHANISMS LINKING SLEEP AND GH SECRETION

Various studies have indicated that cholinergic pathways are involved in controlling GH release including sleep-related GH release in response to various stimuli.7, 8, 9 Furthermore this cholinergic control is effected through the regulation of hypothalamic somatostatin release. Thus it appears that sleep-onset secretion of GH occurs during a period of relative somatostatin withdrawal. In addition, evidence exists that sleep-onset release of GH is regulated by growth hormone-releasing hormone

ALTERATIONS IN SLEEP-RELATED GH SECRETION DURING SEXUAL MATURATION AND AGING

The total amount and the temporal distribution of GH release are strongly dependent on age. Spontaneous secretion of GH is detectable in term infants who appear to have a high level of tonic secretion.22 As an infant matures, the frequency and amplitude of the GH pulses decrease, and tonic secretion diminishes.22 A pulsatile pattern of GH release with increased amplitudes during sleep is present in prepubertal boys and girls.23 During puberty the amplitude but not the frequency of the pulses is

SUMMARY

From early childhood until late adulthood the onset of sleep is a robust stimulus for GH secretion. Most GH pulses during sleep occur in temporal association with SWS. However, GH pulses during sleep may be observed in the absence of SWS, and in studies with standard assay procedures only one third of the SWS periods appear to be associated with detectable GH secretion. The absence of a one-to-one association between SWS and GH secretion is likely to reflect the dual control of GH pulsatility

References (28)

  • FJ Obál et al.

    Inhibition of growth hormone-releasing factor suppresses both sleep and growth hormone secretion in the rat

    Brain Res

    (1991)
  • G Costin et al.

    Growth hormone secretory dynamics in subjects with normal stature

    J Pediatr

    (1989)
  • Y Takahashi et al.

    Growth hormone secretion during sleep

    J Clin Invest

    (1968)
  • A van Coevorden et al.

    Neuroendocrine rhythms and sleep in aging

    Am J Physiol

    (1991)
  • E Van Cauter et al.

    A quantitative estimation of GH secretion in normal man: reproducibility and relation to sleep and time of day

    J Clin Endocrinol Metab

    (1992)
  • RW Holl et al.

    Thirty-second sampling of plasma growth hormone in man: correlation with sleep stages

    J Clin Endocrinol Metab

    (1991)
  • J Golstein et al.

    Effects of “jet lag” on hormonal patterns. Part IV: time shifts increase growth hormone release

    J Clin Endocrinol Metab

    (1983)
  • E Van Cauter

    Computer-assisted analysis of endocrine rhythms

  • WB Mendelson et al.

    Piperidine enhances sleep-related and insulin-induced growth hormone secretion: further evidence for a cholinergic secretory mechanism

    J Clin Endocrinol Metab

    (1981)
  • JR Peters et al.

    Cholinergic muscarinic receptor blockade with pirenzepine abolishes slow-wave sleep-related growth hormone release in normal adult males

    Clin Endocrinol

    (1986)
  • JT McCracken et al.

    Dose-dependent effects of scopolamine on nocturnal growth hormone secretion in normal adult men: relation to δ-sleep changes

    J Clin Endocrinol Metab

    (1991)
  • CA Jaffe et al.

    Suppression of growth hormone (GH) secretion by a selective GH-releasing hormone (GHRH) antagonist

    J Clin Invest

    (1993)
  • E Van Cauter et al.

    Sleep, awakenings and IGF-I modulate the growth hormone secretory response to growth hormone-releasing hormone

    J Clin Endocrinol Metab

    (1992)
  • CL Ehlers et al.

    Effects of corticotropin-releasing factor and growth hormone-releasing factor on sleep and activity in rats

    Neuroendocrinology

    (1986)

    • Cited by (0)

    ☆

    From the Department of Medicine, University of Chicago, Illinois, and the Section of Endocrinology, Hopital Erasme, Université Libre de Bruxelles, Belgium

    ☆☆

    Supported in part by National Institutes of Health grants DK-41814 and AG-11412 and by the Research Network on Mind-Body Interactions of the MacArthur Foundation. During the performance of the studies described in this report, Dr. Plat was supported by the Suzanne and Jean Pirart Fellowship from the Association Belge du Diabète (Brussels, Belgium).

    ★

    Reprint requests: Eve Van Cauter, PhD, Department of Medicine, MC 1027, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637.

    ★★

    0022-3476/96/$5.00 + 0 9/0/72341

    View full text
    Copyright © 1996 Mosby, Inc. All rights reserved.