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Consider the typical metabolic patient profile presenting to a clinic like Meto: Waking at 2–4 AM with an inability to return to sleep (a cortisol signature) Carrying visceral abdominal fat despite dietary effort Elevated fasting glucose or rising HbA1c despite reasonable lifestyle habits Fatigue despite adequate total sleep hours Poor recovery from exercise Blunted GH response (often confirmed on labs as low IGF-1) Each of these findings is consistent with slow-wave sleep deprivation and HPA axis dysregulation

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Gsr deficiency does not increase oxidative damage in mouse cochlea The major sites of cochlear pathology typically include sensory hair cells, spiral ganglion neurons (SGNs) and stria vascularis (SV) [37, 38]