Cortisol dynamics and sleep quality: the role of sex and oral contraceptive use 107 evaluate the role of CAR in possible group differences in sleep. In the case significant group differences are found in aim one, we evaluate whether group differences in the CAR lead to sleep differences (i.e., mediation analysis). In the case of no group differences, we evaluate if the association between the sleep outcomes and CAR differs between the groups (i.e., moderation analysis). 2. Methods 2.1. Study setting and participants For this study, we used data from the Center for Integrated Molecular Brain Imaging (Cimbi) database (Knudsen et al., 2016). Participants were recruited for different research projects at the Neurobiology Research Unit at Copenhagen University Hospital, Rigshospitalet (Denmark). Data were collected between September 2008 and November 2021, and all participants provided informed consent for the inclusion of their data in the Cimbi database. All projects of which data was used were approved by the Ethics Committee of Copenhagen and Frederiksberg or by the Capital Region of Denmark [KF-01-124/04; (KF)01-2006-20; (KF)01-2006-20; (KF)01-2006-20; (KF)01280377; H-1-2010-091; H-1-2010-085; H-2-2010-108; H-4-2011-103; H-4-2012-105; H-3-2012-083; H-3-2013-100; H-6-2014-057; H-2-2014-070; H-15004506; H-16026898; H-15017713]. For the current study, participants were included if they were between 18 and 45 years of age, if they had no current or prior psychiatric or severe somatic illness, reported no psychotropic medication use and if they completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and a CAR measurement within a maximum of a 14-day interval of each other. Participants were grouped based on sex and reported hormonal contraceptive use at the time of the measurements, creating the following 3 groups: (1) naturally cycling (NC) women, (2) women who reported current OC use, and (3) men. We excluded participants whose hormonal contraceptive user status was unknown (n=10), who reported intrauterine device (IUD) use of an unknown type (n=1), who reported hormonal IUD use (n=13, PSQI scores and CAR measurements for these are reported in supplementary materials in
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