What causes the disruption of sleep patterns following prolonged high cortisol levels, such as in Cushing's syndrome?

💡 Explanation

Disrupted sleep occurs because elevated cortisol directly interferes with the hypothalamic-pituitary-adrenal (HPA) axis's normal negative feedback mechanism, leading to altered circadian rhythms. Therefore, the HPA axis is disrupted, rather than other neurotransmitter-specific pathways, which play secondary roles.

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