Sleep EEG effects of anti-gluco- and anti-mineralocorticoids in old-aged men: pilot study

AIM: Age-related sleep changes have been associated with altered hypothalamic-pituitary-adrenal axis reactivity and impaired feedback inhibition at the glucocorticoid (GR) and mineralocorticoid (MR) receptor level. To further investigate the specific role of this binary receptor system in the elderly, sleep electroencephalogram (EEG) effects of the MR antagonist spironolactone and GR antagonist mifepristone in old-aged men were compared in this pilot study.

METHODS: Old-aged healthy men (n = 6, 65-91 years) were treated on three occasions in a single-blinded design in random order with mifepristone, spironolactone and placebo, respectively, and nocturnal sleep EEG was recorded.

RESULTS: Mifepristone led to increased wake time, decreased stage 2 and rapid eye movement (REM) sleep and prolonged REM sleep latency in the first half of the night, whereas spironolactone had no considerable effects on sleep EEG.

CONCLUSION: GR antagonism can potentiate age-related sleep pattern alterations and further support the role of impaired GR signaling in age-related changes in sleep architecture.