Chapter 4 116 Figure 4.2. Cortisol Awakening Response: Cortisol levels per group in the CAR measurements. The left panel shows individual CAR outcomes per group (displayed in dots) and medians and interquartile ranges (displayed in boxplots) of CAR AUCis (in nmol/L*minutes). The right panel shows means and standard deviations of absolute cortisol values (in nmol/L) per timepoint after awakening per group. The CAR is lower in OC users and men compared to NC women. ***: p<0.005. 3.4. The role of the cortisol awakening response in sleep disruptions and sleep quality Sleep quality and CAR: Moderation analyses in NC women and men The associations between CAR and overall sleep quality, as measured using the PSQI sum score, are shown per group in the upper panel of Figure 4.3. In NC women, there was no evidence for an association between PSQI sum score and the CAR (0.002 points per 100 nmol/L*minutes, 95% CI: [-0.14 to 0.15], p=0.97). In men, the PSQI sum score was significantly associated with the CAR, indicating that the PSQI sum score would be lower with a higher CAR, with an average decrease of 0.24 points per 100 nmol/L*minutes increase in the CAR (95% CI: [-0.40 to -0.08], p<0.01). The association between the PSQI sum score and the CAR was significantly different in men compared to NC women (-0.244 points per 100 nmol/L*minutes increase in CAR, 95% CI [-0.454 to -0.034], p=0.023). As displayed in Table 4.3, covariatecontrolled models show estimated results with similar directions and effect size magnitudes.
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