Cortisol dynamics and sleep quality: the role of sex and oral contraceptive use 115 Table 4.2. Self-reported sleep quality and sleep disruptions per group. In the reported probabilistic indexes in the sleep disruption outcomes, a value of 0.5 represents no differences between the groups. Sleep quality (PSQI sum score) NC women OC users Men N 87 31 124 Mean, SD 3.6 (1.7) 4.6 (2.5) 4.0 (2.5) Median, IQR 4 (2 to 5) 4 (2.5 to 6) 4 (2 to 5) Marginal model Estimate, 95% CI, p Reference 0.97 0.14 to 1.81 p=0.023 0.35 -0.20 to 0.92 p=0.21 Age-controlled model Estimate, 95% CI, p Reference 0.99 0.15 to 1.82 p=0.021 padjusted=0.042 a. 0.34 -0.22 to 0.90 p=0.23 Sleep disruptions (PSQI 5B) NC women OC users Men n 87 31 124 1: Not during past month n (%) 19 (21.8%) 8 (25.8%) 39 (31.5%) 2: Less than once a week n (%) 35 (40.2%) 9 (29.0%) 39 (31.5%) 3: Once or twice a week n (%) 22 (25.3%) 10 (32.3%) 30 (24.2%) 4: Three or more times a week n (%) 11 (12.6%) 4 (12.9%) 16 (12.9%) Marginal probabilistic index Estimate, 95% CI, p Reference 0.51 0.40 to 0.63 p=0.84 0.47 0.39 to 0.54 p=0.40 Age-controlled probabilistic index Estimate, 95% CI, p Reference 0.52 0.40 to 0.64 p=0.73 padjusted=0.73 a. 0.45 0.38 to 0.53 p=0.21 a. P-values were adjusted for the primary analysis aims (i.e., for two tests, both age-controlled comparisons of NC women vs. OC users) using Bonferroni-Holm adjustments. Confidence intervals were not adjusted for multiple comparisons. 3.3. CAR measurement characteristics The CAR was missing for 14 participants, of whom 3 NC women, 3 OC users and 8 men. OC users more frequently measured the CAR on their day off (59.4%) compared to NC women (28.6%) and men (43.5%). Table 4.1 shows the testing days, the absolute cortisol awakening levels and the CAR per group, and the distribution of the CARs and absolute mean values of cortisol per time point are visualized in Figure 4.2. The mean CAR was lower in OC users compared to NC women (-244.3 nmol/L*minutes, 95% CI=-375.0 to -113.7, p<0.005) and lower in men compared to NC women (-146.1 nmol/L*minutes, 95% CI=-246.2 to -46.0, p<0.005) after adjusting for age, smoking status and work vs. day off status of sampling day: these results are also displayed in Table 4.1. Please note that these results were expected based on the studies by Høgsted et al. (2021) and Nasser et al. (2023), whose samples considerably overlap with the current study sample.
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