Gender differences in sleep endocrine regulation following administration of growth-hormone releasing hormone (GHRH) – relevance for the pathophysiology of major depression

Hypothalamic peptide hormones GHRH and corticotropin-releasing hormone (CRH) are critically involved in sleep-endocrine regulation. While GHRH promotes sleep, CRH induces arousal (1).

We examined the sleep EEG in drug-free patients with an acute episode of major depression and age- and sex-matched controls during two consecutive nights with randomised application of GHRH (50µg every hour from 2200 to 0100h) or placebo. MANCOVA was performed.

Sleep-endocrine alterations typically associated with major depression were noted primarily in male and elderly female patients. GHRH had a beneficial effect on these sleep alterations in male patients, while in female patients, GHRH further augmented the sleep disturbances. The latter was most prominently observed in females with atypical features of depression. These data support the hypotheses 1) that gender modulates the pathophysiology of major depression and 2) that in patients with atypical features neuroendocrine alterations other than CRH oversecretion are critically involved.

1. Ehlers, C.L. et al. Neuroendocrinology 42 (1986) 467–474