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Christina Antza Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Georgios Kostopoulos Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece

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Samiul Mostafa Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Krishnarajah Nirantharakumar Institute of Applied Health Research, University of Birmingham, Birmingham, UK
Centre of Endocrinology Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

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Abd Tahrani Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Centre of Endocrinology Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

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prevalence, sleep insufficiency has become part of the modern lifestyle, across all age groups ( Gangwisch et al. 2005 , Basch et al. 2014 , Owens et al. 2014 , Gordon et al. 2019 , Toyoura et al. 2020 ). The average sleep duration dropped from

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Sophie M T Wehrens Centre for Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK

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Shelagh M Hampton Centre for Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK

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Rebecca E Finn Centre for Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK

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Debra J Skene Centre for Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK

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to minimise sleep debt, volunteers were asked to maintain a self-selected regular sleep–wake cycle with a sleep duration of 7.5 or 8 h for 8 days prior to the laboratory study (bed time 23.3±0.5 h (mean± s.d. ), range 22–24 h, wake up time 7.2±0.5 h

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Daniela Leite de Oliveira Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil

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Camila Hirotsu Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil

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Sergio Tufik Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil

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Monica Levy Andersen Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil

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of 25OHD concentrations were associated with shorter sleep duration (<8 h) in female teenagers. In this study, sleep duration was assessed by self-administered questionnaires, which only provide subjective information about the sleep pattern of

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Kanta Kon Department of Clinical Pharmacology, University of Toyama, Sugitani, Toyama, Japan

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Hiroshi Tsuneki Department of Clinical Pharmacology, University of Toyama, Sugitani, Toyama, Japan

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Hisakatsu Ito Department of Anesthesiology, University of Toyama, Sugitani, Toyama, Japan

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Yoshinori Takemura Department of Anesthesiology, University of Toyama, Sugitani, Toyama, Japan

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Kiyofumi Sato Department of Clinical Pharmacology, University of Toyama, Sugitani, Toyama, Japan

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Mitsuaki Yamazaki Department of Anesthesiology, University of Toyama, Sugitani, Toyama, Japan

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Yoko Ishii Department of Pathology, University of Toyama, Sugitani, Toyama, Japan

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Masakiyo Sasahara Department of Pathology, University of Toyama, Sugitani, Toyama, Japan

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Assaf Rudich Department of Clinical Biochemistry and Pharmacology, Ben-Gurion University of the Negev, Beer-Sheva, Israel

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Takahiro Maeda Department of Clinical Pharmacology, University of Toyama, Sugitani, Toyama, Japan

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Tsutomu Wada Department of Clinical Pharmacology, University of Toyama, Sugitani, Toyama, Japan

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Toshiyasu Sasaoka Department of Clinical Pharmacology, University of Toyama, Sugitani, Toyama, Japan

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metabolism ( Knutson & Van Cauter 2008 , Qian et al. 2016 ). Several studies have demonstrated that behavioral interventions for optimizing sleep duration improve glucose metabolism; however, it remains uncertain whether drug treatment of insomnia could

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Jonathan D Johnston Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK

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Debra J Skene Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK

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treatment of circadian rhythm sleep–wake disorders. Melatonin as an endocrine calendar The 24-h melatonin signal not only represents endogenous circadian time but also encodes seasonal information. Specifically, the duration of elevated melatonin

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David E Henley Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Faculty of Medicine, Clinical Biochemistry, University of Bristol, Bristol BS1 3NY, UK
Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Faculty of Medicine, Clinical Biochemistry, University of Bristol, Bristol BS1 3NY, UK

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Fiona Buchanan Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Faculty of Medicine, Clinical Biochemistry, University of Bristol, Bristol BS1 3NY, UK

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Rosemary Gibson Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Faculty of Medicine, Clinical Biochemistry, University of Bristol, Bristol BS1 3NY, UK

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Jennie A Douthwaite Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Faculty of Medicine, Clinical Biochemistry, University of Bristol, Bristol BS1 3NY, UK

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Susan A Wood Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Faculty of Medicine, Clinical Biochemistry, University of Bristol, Bristol BS1 3NY, UK

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Wolfram W Woltersdorf Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Faculty of Medicine, Clinical Biochemistry, University of Bristol, Bristol BS1 3NY, UK

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James R Catterall Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Faculty of Medicine, Clinical Biochemistry, University of Bristol, Bristol BS1 3NY, UK

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Stafford L Lightman Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Faculty of Medicine, Clinical Biochemistry, University of Bristol, Bristol BS1 3NY, UK

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Introduction Obstructive sleep apnea (OSA) is a common condition, with an estimated prevalence of 3–7% for adult men and 2–5% for adult women in the general population ( Punjabi 2008 ). It is associated with intermittent upper airway obstruction and

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Michael Hastings Division of Neurobiology, MRC Laboratory of Molecular Biology, Hills Road, Cambridge CB2 0QH, UK

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John S O’Neill Division of Neurobiology, MRC Laboratory of Molecular Biology, Hills Road, Cambridge CB2 0QH, UK

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Elizabeth S Maywood Division of Neurobiology, MRC Laboratory of Molecular Biology, Hills Road, Cambridge CB2 0QH, UK

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, recurrent and persistent changes are those that occur over the 24-h solar cycle. As we engage with the world during daytime wakefulness and then withdraw from it during nocturnal sleep, our bodies alternate between catabolic and anabolic states, thereby

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Shannon M Bailey Division of Molecular and Cellular Pathology, Division of Cardiovascular Diseases, Department of Pathology

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Uduak S Udoh Division of Molecular and Cellular Pathology, Division of Cardiovascular Diseases, Department of Pathology

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Martin E Young Division of Molecular and Cellular Pathology, Division of Cardiovascular Diseases, Department of Pathology

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-Louis G Brown CD Ogedegbe G Boutin-Foster C McFarlane SI 2010 Sleep duration and the risk of diabetes mellitus: epidemiologic evidence and pathophysiologic insights . Current Diabetes Reports 10 43 – 47 . ( doi:10.1007/s11892-009-0082-x

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T Akamizu Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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T Murayama Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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S Teramukai Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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K Miura Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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I Bando Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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T Irako Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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H Iwakura Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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H Ariyasu Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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H Hosoda Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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H Tada Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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A Matsuyama Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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S Kojima Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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T Wada Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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Y Wakatsuki Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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K Matsubayashi Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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T Kawakita Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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A Shimizu Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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M Fukushima Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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M Yokode Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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K Kangawa Ghrelin Research Project and
Post-genome Project, Department of Experimental Therapeutics, Kyoto University Hospital, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
Department of Clinical Innovative Medicine, and
Department of Clinical Trial Design and Management, Kyoto University Hospital, Kyoto 606-8507, Japan
Translational Research Center, Kyoto University Hospital, and Department of Geriatric Medicine, Kyoto University School of Medicine, Kyoto 606-8507, Japan
Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan
Kyoto Preventive Medical Centre, Kyoto 604-8491, Japan
Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka 565-8565, Japan

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information about their sleeping time duration, bowel movements, smoking habits, alcohol consumption, use of medication, past medical history and physical activity. The question about bowel frequency was, ‘How often do you usually defecate – once a day, more

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Ryun S Ahn
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Jee H Choi Graduate School of Integrative Medicine, Hormone Research Center, Department of Obstetrics and Gynecology, Department of Family Medicine, Department of Life sciences, Research Institute of Integrative Medicine, CHA Medical University, Yuksam‐dong 605, Kangnamgu, Seoul 135-907, Republic of Korea

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Bum C Choi Graduate School of Integrative Medicine, Hormone Research Center, Department of Obstetrics and Gynecology, Department of Family Medicine, Department of Life sciences, Research Institute of Integrative Medicine, CHA Medical University, Yuksam‐dong 605, Kangnamgu, Seoul 135-907, Republic of Korea

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Jung H Kim Graduate School of Integrative Medicine, Hormone Research Center, Department of Obstetrics and Gynecology, Department of Family Medicine, Department of Life sciences, Research Institute of Integrative Medicine, CHA Medical University, Yuksam‐dong 605, Kangnamgu, Seoul 135-907, Republic of Korea

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Sung H Lee Graduate School of Integrative Medicine, Hormone Research Center, Department of Obstetrics and Gynecology, Department of Family Medicine, Department of Life sciences, Research Institute of Integrative Medicine, CHA Medical University, Yuksam‐dong 605, Kangnamgu, Seoul 135-907, Republic of Korea

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Simon S Sung Graduate School of Integrative Medicine, Hormone Research Center, Department of Obstetrics and Gynecology, Department of Family Medicine, Department of Life sciences, Research Institute of Integrative Medicine, CHA Medical University, Yuksam‐dong 605, Kangnamgu, Seoul 135-907, Republic of Korea

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by the HPO axis and the ovarian cycle. It is known that the CAR is influenced by various factors, such as stress-related factors (job stress and life stress), sleep-related factors (sleep duration and sleep quality), and awakening factors (forced

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