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The interplay between the somatotropic axis and sleep regulation has been extensively documented in both preclinical and clinical studies, demonstrating the integral role of growth hormonereleasing hormone (GHRH), somatostatin, GH itself, insulin-like growth factor-I (IGF-I), synthetic GH secretagogues, and ghrelin in modulating sleep architecture ( In normal individuals, sleep-onset GH secretion appears to be primarily regulated by GHRH stimulation during a period of relative somatostatin withdrawal

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Notably, we found the fecal metabolite profile of both subgroups abundant in amino acids, peptides, and analogs, with decreases in sulfates, furanones, and quaternary ammonium salts and increases in cholestane steroids, carboxylic acid derivatives, and imidazoles (Fig