Glucocorticoids and Sleep: Dr. Friedman’s NIH Research
Dr. Friedman, when he was a fellow at the NIH in the 1990s, published a paper in the Journal of Clinical Endocrinology and Metabolism on the timing of giving glucocorticoids to patients with Addison disease. This paper involved sleep studies, and Dr. Friedman and colleagues found that a small dose of hydrocortisone given at bedtime helped the patients with Addison disease go into deep sleep while if the glucocorticoids were withheld for 1-1/2 days, the patient did not go into deep sleep. It is commonly known that excess glucocorticoids give trouble sleeping, but this paper showed that glucocorticoid insufficiency is also associated with poor sleep and that it is beneficial to give a small amount (2.5 mg) of glucocorticoids at bedtime. Almost all of Dr. Friedman’s patients sleep better with this low dose.
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