DSIP (Delta Sleep-Inducing Peptide) Dosage Guide

Evidence-based protocols for the naturally occurring sleep-modulating nonapeptide — sleep architecture normalization, stress reduction, circadian rhythm support, stacking, cycling, and safety.

Last reviewed February 24, 2026
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Delta Sleep-Inducing Peptide

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What Is DSIP?

DSIP (Delta Sleep-Inducing Peptide) is a naturally occurring nonapeptide (9 amino acids) with the sequence Trp-Ala-Gly-Gly-Asp-Ala-Ser-Gly-Glu. It was first isolated in 1977 from the cerebral venous blood of rabbits placed in an induced sleep state by Schoenenberger and Monnier. Since then, DSIP has been identified in human blood, cerebrospinal fluid, and breast milk, confirming its endogenous role in mammalian physiology.

Despite its name, DSIP is not a sedative. The name “Delta Sleep-Inducing Peptide” is somewhat misleading — DSIP does not force sleep or induce unconsciousness. Instead, it modulates sleep architecture by promoting and normalizing natural slow-wave (delta) sleep — the deepest, most restorative phase of non-REM sleep (stage 3/4 NREM). It achieves this through interactions with GABA, serotonin, and hypothalamic sleep centers without causing sedation, respiratory depression, or next-morning grogginess.

Beyond sleep, DSIP has demonstrated a remarkably diverse pharmacological profile. It modulates the hypothalamic-pituitary-adrenal (HPA) axis — normalizing cortisol and ACTH levels in stressed individuals. It influences LH (luteinizing hormone) release, has antioxidant properties, and modulates pain perception. Research has also explored its potential in opioid and alcohol withdrawal support, where it appears to reduce withdrawal symptoms and normalize disrupted sleep patterns.

Use our Peptide Dosage to calculate your exact dose based on vial size and concentration.

Dosing information in this guide is derived from clinical studies, published research, and community protocols — not from approved pharmaceutical labeling.

Key Characteristics:

  • Naturally occurring nonapeptide9 amino acids (Trp-Ala-Gly-Gly-Asp-Ala-Ser-Gly-Glu); found endogenously in human blood, CSF, and breast milk
  • Not a sedativenormalizes disturbed sleep architecture by promoting slow-wave (delta) sleep without forcing sleep, sedation, or respiratory depression
  • Multi-system modulatoraffects GABA, serotonin, hypothalamic sleep centers, HPA axis (cortisol/ACTH), LH release, pain perception, and antioxidant pathways
  • Short half-life, long-lasting effectsplasma half-life of ~15–25 minutes, but effects on sleep architecture persist throughout the night via downstream neurotransmitter modulation
  • Stress-sleep connectionnormalizes cortisol and ACTH levels, making it particularly effective for stress-related sleep disruption
  • No dependence or withdrawalunlike benzodiazepines, Z-drugs, or opioids, DSIP does not cause physical dependence, tolerance, or rebound insomnia upon discontinuation

For a complete overview of its mechanism and research, see our full DSIP profile. New to peptides? Start with the Beginner's Guide to Peptides.

How DSIP Dosage Is Determined

DSIP dosing is informed by a combination of early clinical studies, pharmacological research, and community experience. The original isolation and characterization studies by Schoenenberger, Monnier, and subsequently by Graf and Kastin established the foundational understanding of DSIP's dose-response characteristics and pharmacokinetics in both animals and humans.

Early Clinical & Pharmacological Studies

Schneider-Helmert and Schoenenberger conducted some of the earliest human studies on DSIP for insomnia, using intravenous doses of approximately 25 nmol/kg (roughly equivalent to 150–250 mcg for an average adult). These studies demonstrated improved sleep onset latency, increased slow-wave sleep duration, and reduced nighttime awakenings — without the hangover effects associated with conventional hypnotics. Subsequent subcutaneous dosing studies confirmed similar effects in the 100–300 mcg range.

Pharmacokinetics & Half-Life

DSIP has a remarkably short plasma half-life of approximately 15–25 minutes due to rapid enzymatic degradation by aminopeptidases and endopeptidases. However, the functional effects on sleep persist for hours — indicating that DSIP triggers downstream signaling cascades (GABAergic facilitation, serotonin modulation, hypothalamic activation) that outlast the peptide's presence in circulation. This disconnect between plasma half-life and functional duration is critical for understanding why a single pre-bedtime dose provides benefit throughout the night.

Stress & HPA Axis Research

Kato, Graf, and colleagues demonstrated DSIP's ability to modulate the hypothalamic-pituitary-adrenal (HPA) axis, reducing elevated cortisol and ACTH levels in stressed subjects. This cortisol-normalizing effect is particularly relevant for sleep, as elevated evening cortisol is a primary driver of stress-related insomnia and poor sleep quality. The effective doses for HPA modulation overlap with the standard sleep-promoting doses (100–300 mcg).

Withdrawal & Pain Research

Dick and colleagues explored DSIP's role in opioid and alcohol withdrawal, finding that it reduced withdrawal symptoms and helped normalize sleep architecture disrupted by substance dependence. The analgesic/pain-modulating properties of DSIP have been documented in both animal and human studies, with effects mediated through opioidergic pathway interactions at standard dosing ranges.

Strength of evidence: Moderate (early-stage). DSIP has been studied in multiple human clinical trials since the late 1970s, with consistent findings on sleep architecture modulation and stress reduction. However, large-scale randomized controlled trials are lacking, and much of the dose-response data comes from small studies and community experience. The 100–300 mcg dosing range is well-established but not FDA-validated.

Standard DSIP Dosage Ranges

DSIP is primarily administered by subcutaneous injection 30–60 minutes before bedtime. The effective dose range is 100–300 mcg for most users. DSIP does not require fasting — unlike GH-releasing peptides, its mechanism is not dependent on blood glucose or free fatty acid levels.

Dosage by Experience Level

LevelDoseTimingFrequencyNotes
Beginner100 mcg30–60 min before bedNightlyStart here to assess tolerance; effective for many users
Intermediate200 mcg30–60 min before bedNightlyStandard dose for most protocols; good balance of efficacy and side effects
Advanced300 mcg30–60 min before bedNightlyUpper end of standard range; minimal additional benefit over 200 mcg for most
Stress Protocol100 mcg AM + 200 mcg PMMorning + 30–60 min before bedDailySplit dosing for acute stress periods; daytime dose targets HPA axis cortisol modulation

Timing Guidelines

  • 30–60 minutes before bed: This is the optimal window. DSIP's short half-life means it begins modulating sleep pathways within minutes, and the 30–60 minute lead time allows GABAergic and serotonergic facilitation to engage before sleep onset.
  • Consistent timing matters: Administer at the same time each night to reinforce circadian rhythm normalization. Irregular timing undermines one of DSIP's key benefits.
  • No fasting requirement: Unlike GH-releasing peptides, DSIP's mechanism does not depend on metabolic state. You can eat normally before administration.
  • Pair with sleep environment: Dim lighting, cool room temperature (65–68°F / 18–20°C), and reduced screen exposure enhance DSIP's effects on sleep architecture.

Administration Methods

DSIP can be administered via two primary routes: subcutaneous injection and intranasal spray. Each has distinct advantages and trade-offs in terms of bioavailability, convenience, and dosing precision.

ParameterSubcutaneous InjectionIntranasal Spray
BioavailabilityHigh (~90%+)Lower & variable (~30–60%)
Dosing PrecisionExcellent (insulin syringe)Moderate (spray volume varies)
Typical Dose Range100–300 mcg200–400 mcg (higher to offset lower absorption)
Onset of Effects5–15 minutes5–20 minutes
ConvenienceRequires reconstitution & injection suppliesNeedle-free; more convenient for travel
Recommended ForPrimary route; most research-supportedUsers who prefer needle-free administration
Subcutaneous injection is recommended for consistent and reliable dosing. Most clinical research on DSIP used the injectable route. Intranasal is a viable alternative for convenience, but expect to use 50–100% higher doses to compensate for lower and more variable bioavailability. Nasal congestion, mucosal inflammation, or recent nasal spray use can further reduce intranasal absorption.

Subcutaneous Injection Sites

  • Abdomen (preferred): 2 inches from the navel; consistent absorption
  • Upper thigh: Outer/front of thigh; alternative site
  • Upper arm: Back of upper arm; less convenient for self-injection
  • Rotate sites: Alternate injection sites to prevent tissue irritation

Calculate Your DSIP Dose

DSIP is supplied as a lyophilized (freeze-dried) powder, typically in 2 mg or 5 mg vials. You reconstitute it with bacteriostatic water, then draw your dose using an insulin syringe. The concentration depends on how much water you add to the vial.

Worked Example:

  • Vial size: 5 mg (5,000 mcg) of DSIP
  • Bacteriostatic water added: 2.5 mL
  • Concentration: 5,000 mcg ÷ 2.5 mL = 2,000 mcg per mL
  • Target dose: 200 mcg
  • Volume to draw: 200 ÷ 2,000 = 0.1 mL = 10 units on an insulin syringe

Quick Reference — 5 mg Vial

Bac Water AddedConcentration100 mcg Dose200 mcg Dose300 mcg Dose
1 mL5,000 mcg/mL2 units (0.02 mL)4 units (0.04 mL)6 units (0.06 mL)
2 mL2,500 mcg/mL4 units (0.04 mL)8 units (0.08 mL)12 units (0.12 mL)
2.5 mL2,000 mcg/mL5 units (0.05 mL)10 units (0.1 mL)15 units (0.15 mL)
5 mL1,000 mcg/mL10 units (0.1 mL)20 units (0.2 mL)30 units (0.3 mL)

Quick Reference — 2 mg Vial

Bac Water AddedConcentration100 mcg Dose200 mcg Dose
1 mL2,000 mcg/mL5 units (0.05 mL)10 units (0.1 mL)
2 mL1,000 mcg/mL10 units (0.1 mL)20 units (0.2 mL)

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DSIP Dosage by Goal

DSIP's multi-system effects make it applicable to several goals beyond basic sleep improvement. The optimal protocol varies depending on whether you are targeting sleep architecture, stress reduction, circadian rhythm repair, or adjunctive support for pain or withdrawal management.

Sleep Quality & Slow-Wave Sleep Enhancement

The primary use case for DSIP. Targets individuals with poor sleep quality, light sleepers, those with reduced deep sleep, or anyone seeking more restorative sleep without the side effects of pharmaceutical sleep aids. DSIP promotes stage 3/4 NREM (delta) sleep — the phase most critical for physical recovery, immune function, and memory consolidation.

  • Dose: 100–200 mcg SubQ
  • Timing: 30–60 minutes before bed
  • Cycle: 2–4 weeks on, 1–2 weeks off
  • Expected timeline: Improved sleep within 1–3 nights; full effect on architecture at 5–7 days

Stress-Related Insomnia & Cortisol Normalization

For individuals whose sleep is primarily disrupted by stress, anxiety, or elevated evening cortisol. DSIP's HPA axis modulation normalizes cortisol and ACTH levels, addressing the root cause of stress-related sleep disruption rather than merely masking symptoms. This protocol may include a daytime dose for acute stress management.

  • Dose: 100 mcg AM (optional, for daytime stress) + 200 mcg before bed
  • Timing: Morning dose any time; evening dose 30–60 min before bed
  • Cycle: 2–4 weeks during high-stress periods
  • Note: The AM dose is specifically for cortisol modulation, not for daytime sleep promotion. DSIP will not cause daytime drowsiness at 100 mcg.

Circadian Rhythm Normalization

For shift workers, travelers with jet lag, or individuals with delayed/advanced sleep phase disorder. Consistent DSIP administration at a fixed pre-bedtime helps entrain the circadian rhythm to the desired sleep schedule. This works best when combined with timed light exposure and consistent wake times.

  • Dose: 100–200 mcg SubQ
  • Timing: 30–60 minutes before desired sleep onset (not current sleep time — target the new schedule)
  • Cycle: 2–3 weeks or until rhythm is established
  • Combine with: Low-dose melatonin (0.3–0.5 mg) at the same time for circadian signaling; bright light exposure upon waking
Circadian rhythm correction takes time. Do not expect immediate schedule shifts. DSIP helps facilitate the transition by promoting deep sleep at the target time, but the full circadian adjustment typically takes 5–10 days of consistent protocol adherence. Be patient and maintain the schedule rigidly during the correction period.

Recovery & Nocturnal GH Enhancement

For athletes, active individuals, or those seeking enhanced physical recovery. DSIP promotes the deep slow-wave sleep during which the largest natural GH pulses occur. By deepening and extending stage 3/4 NREM sleep, DSIP indirectly supports greater nocturnal GH release — benefiting muscle repair, tissue regeneration, and overall recovery.

  • Dose: 200–300 mcg SubQ
  • Timing: 30–60 minutes before bed
  • Cycle: 3–4 weeks on, 2 weeks off
  • Stack: Pairs well with Ipamorelin (direct GH stimulus during deeper sleep) or BPC-157 (tissue repair synergy)

Chronic Pain & Pain-Related Sleep Disruption

DSIP has demonstrated pain-modulating properties through interactions with opioidergic pathways. For individuals whose sleep is disrupted by chronic pain, DSIP offers a dual benefit: improved sleep quality and direct pain perception modulation. This application is primarily supported by animal studies and small human trials.

  • Dose: 200–300 mcg SubQ
  • Timing: 30–60 minutes before bed
  • Cycle: 2–4 weeks on, 1–2 weeks off
  • Note: DSIP is not a replacement for proper pain management. Consult a healthcare provider for chronic pain treatment.
Sleep is foundational. Regardless of your specific goal, improved sleep quality benefits virtually every physiological system — from immune function to cognitive performance to body composition. DSIP's value extends beyond any single application because better sleep amplifies the effectiveness of everything else you do for your health.

Cycling & Duration

Unlike some peptides where cycling is optional, structured cycling with DSIP is recommended to maintain effectiveness and allow endogenous sleep regulatory systems to function independently. DSIP does not cause physical dependence or withdrawal, but cycling helps ensure the peptide retains its full efficacy across multiple uses.

Cycling Protocols

ProtocolOn-CycleOff-CycleBest For
Short Cycle2 weeks1 week offOccasional sleep disruption; jet lag recovery; short stress periods
Standard Cycle3–4 weeks1–2 weeks offMost users; chronic sleep issues; ongoing stress management
As-NeededIndividual nightsN/AOccasional use for travel, high-stress days, or disrupted schedules
Extended (supervised)4–6 weeks2–3 weeks offUnder healthcare provider guidance; severe chronic insomnia

What to Do During Off-Cycles

The off-cycle period is an opportunity to consolidate the sleep improvements established during the DSIP cycle. During off-periods:

  • Maintain strict sleep hygiene: consistent bed/wake times, dark cool room, no screens 60 minutes before bed
  • Consider low-dose melatonin (0.3–0.5 mg) if needed for circadian support
  • Continue any non-peptide sleep supports: magnesium glycinate, L-theanine, or glycine
  • Monitor whether sleep quality is maintained — if improvements persist without DSIP, you may not need another cycle immediately
Many users find that DSIP's benefits persist after the cycle ends. Because DSIP normalizes sleep architecture rather than forcing sleep through sedation, the improvements to sleep patterns can carry over into the off-cycle period. This is fundamentally different from pharmaceutical sleep aids, which typically produce rebound insomnia when stopped.

DSIP Stacking Protocols

DSIP stacks well with peptides that complement its sleep-promoting and stress-reducing effects. The most effective stacks pair DSIP with peptides that either enhance the sleep environment (anxiolytics, GH secretagogues) or benefit from improved sleep quality (tissue repair, recovery).

DSIP + Ipamorelin — Sleep + GH Synergy

The premier sleep-and-recovery stack. DSIP deepens slow-wave sleep (the phase during which the largest natural GH pulses occur), while Ipamorelin directly triggers GH release from the pituitary. Together, they create both the optimal sleep environment for GH secretion and a direct GH stimulus occurring during that deeper sleep — a true synergistic combination.

CompoundDoseTimingPurpose
DSIP100–200 mcg SubQ30–60 min before bedDeepen slow-wave sleep; enhance natural nocturnal GH pulse environment
Ipamorelin200–300 mcg SubQBefore bed (fasted 2+ hours)Direct GH release trigger; clean GHRP with minimal cortisol/prolactin
Why Ipamorelin specifically? Ipamorelin is the cleanest GHRP — minimal cortisol and prolactin elevation, no significant appetite increase, and very low desensitization risk. This matters for a sleep stack because cortisol elevation (seen with Hexarelin or GHRP-2) would directly counteract DSIP's cortisol-normalizing benefits. Ipamorelin preserves the stress-reduction effects of DSIP while adding direct GH stimulation.

DSIP + BPC-157 — Sleep + Gut-Brain Axis + Tissue Repair

Combines DSIP's sleep normalization with BPC-157's tissue repair and gut-brain axis modulation. BPC-157 has demonstrated effects on dopamine, serotonin, and GABA systems — many of which overlap with sleep regulation. This stack supports both physical recovery (through better sleep and direct tissue repair) and neurological balance.

CompoundDoseTimingPurpose
DSIP100–200 mcg SubQ30–60 min before bedSleep architecture normalization; stress reduction
BPC-157250 mcg SubQ1–2x daily (any time)Tissue repair, gut-brain axis modulation, neurotransmitter support

DSIP + Selank — Sleep + Anxiety Reduction

For users whose sleep disruption is primarily driven by anxiety, rumination, or an overactive mind at bedtime. Selank is a synthetic peptide with anxiolytic and nootropic properties that modulates GABA, serotonin, and BDNF. Combined with DSIP, this stack addresses both the cognitive/emotional drivers of insomnia (via Selank's anxiolytic effects) and the sleep architecture itself (via DSIP).

CompoundDoseTimingPurpose
DSIP100–200 mcg SubQ30–60 min before bedSleep architecture; slow-wave sleep promotion
Selank250–500 mcg intranasal1–2x daily; evening dose 1–2 hours before bedAnxiolytic effects; GABA/serotonin modulation; reduces rumination

DSIP + Ipamorelin + CJC-1295 — Full Nocturnal Recovery Stack

The most comprehensive sleep-and-recovery stack for advanced users. DSIP provides the deep sleep environment, Ipamorelin triggers the GH pulse, and CJC-1295 amplifies and sustains it. This maximizes both sleep quality and nocturnal GH output for recovery, body composition, and anti-aging benefits.

CompoundDoseTimingPurpose
DSIP200 mcg SubQ30–60 min before bedDeep slow-wave sleep; optimal environment for GH release
Ipamorelin200–300 mcg SubQBefore bed (fasted)Direct GH pulse trigger (GHS-R1a)
CJC-1295 (no-DAC)100 mcg SubQWith Ipamorelin injectionAmplifies and sustains GH pulse (GHRH receptor synergy)

Explore more combinations with our Peptide Stack Builder or browse the Top 10 Peptide Stacks guide.

Safety, Side Effects & Contraindications

Common Side Effects

Mild and dose-dependent:

  • Morning grogginess — the most common side effect; almost always indicates the dose is too high. Reduce by 50–100 mcg to resolve.
  • Injection site redness or mild irritation — standard for subcutaneous injections; rotate sites
  • Vivid dreams — reported by some users during the first few nights; typically fades with continued use and reflects deepened sleep architecture
  • Mild headache — rare; usually resolves within the first 2–3 days of use

Uncommon:

  • Mild flushing or warmth post-injection — harmless vasodilation effect
  • Transient nausea — very rare; associated with intranasal administration more than subcutaneous
  • Slight drop in blood pressure — DSIP has mild hypotensive effects in some individuals; relevant for those already on antihypertensive medications
No dependence, no withdrawal, no rebound insomnia. This is one of DSIP's key advantages over pharmaceutical sleep aids. Unlike benzodiazepines, Z-drugs, or antihistamine sleep aids, DSIP does not produce physical dependence, tolerance (in the pharmacological sense), or rebound insomnia when discontinued. Sleep quality typically remains improved for days to weeks after stopping, then gradually returns to baseline.

Contraindications

  • Pregnancy and breastfeeding — insufficient safety data. Although DSIP is found naturally in breast milk, exogenous administration during pregnancy or nursing has not been studied. Avoid entirely.
  • Severe hypotension — DSIP has mild blood pressure-lowering effects. Individuals with already-low blood pressure or those on multiple antihypertensive medications should use caution.
  • Concurrent use of CNS depressants — while DSIP is not sedating, combining it with benzodiazepines, barbiturates, opioids, or high-dose alcohol could produce unpredictable effects. Consult a healthcare provider.
  • Known hypersensitivity — allergic reactions to peptide products, while rare, are possible. Discontinue immediately if allergic symptoms occur.
  • Epilepsy or seizure disorders — DSIP's effects on GABAergic systems mean it could theoretically interact with seizure thresholds. Use only under medical supervision in individuals with seizure history.

When to Reduce Dose or Discontinue

  • Persistent morning grogginess that does not resolve after 2–3 days — reduce dose by 50–100 mcg
  • Unusual drowsiness during the day — dose too high or administered too late at night
  • Headaches that persist beyond the first 3–4 days of use
  • Any sign of allergic reaction: rash, swelling, difficulty breathing — discontinue immediately
  • Dizziness or lightheadedness upon standing — may indicate blood pressure effects; check BP and consider reducing dose
Regulatory Status: DSIP is not FDA-approved for human use. It is classified as a research peptide / research chemical worldwide. It is not scheduled as a controlled substance in most jurisdictions but is not approved for therapeutic use. Regulations vary by country — verify your local laws before purchasing.

Common DSIP Dosing Mistakes

Avoid these common errors to get the most out of your DSIP protocol:

Frequently Asked Questions

Key Takeaways

  • DSIP is not a sedative — it normalizes sleep architecture by promoting slow-wave (delta) sleep without forcing sleep, causing sedation, or producing next-day grogginess
  • Standard dose: 100–300 mcg SubQ, 30–60 minutes before bed — start at 100 mcg and increase only if needed; morning grogginess means the dose is too high
  • Short half-life (~15–25 min), long-lasting effects — DSIP triggers downstream neurotransmitter cascades that persist throughout the night despite the peptide's rapid clearance
  • Stress-sleep connection: DSIP modulates the HPA axis, normalizing cortisol and ACTH — making it particularly effective for stress-related sleep disruption
  • No dependence, tolerance, or withdrawal — fundamentally different from pharmaceutical sleep aids; no rebound insomnia upon discontinuation
  • Cycle 2–4 weeks on, 1–2 weeks off — cycling maintains effectiveness and supports endogenous sleep regulation
  • Best stack: DSIP + Ipamorelin for synergistic sleep depth and nocturnal GH release; add CJC-1295 for maximum GH amplification
  • Pair with sleep hygiene: DSIP works best as a complement to good sleep practices — not a replacement. Consistent timing, dark room, and reduced stimulation are essential.
  • Subcutaneous injection is preferred over intranasal for reliable dosing and consistent bioavailability
  • Not FDA-approved — classified as a research peptide. Consult a healthcare provider before use, especially if taking other medications.

This article is for educational and informational purposes only. See our Disclaimer.

References

  1. Schoenenberger GA, Monnier M. “Characterization of a delta-electroencephalogram (-sleep)-inducing peptide.” Proc Natl Acad Sci U S A.1977;74(3):1282-1286. PubMed
  2. Schneider-Helmert D, Schoenenberger GA. “Effects of DSIP in man: multifunctional psychophysiological properties besides induction of natural sleep.” Neuropsychobiology. 1983;9(4):197-206. PubMed
  3. Graf MV, Kastin AJ. “Delta-sleep-inducing peptide (DSIP): a review.” Neurosci Biobehav Rev. 1984;8(1):83-93. PubMed
  4. Prudchenko IA, et al. “Structure-activity relationship studies of DSIP analogs.” Peptides. 1995;16(6):1075-1080.
  5. Dick P, et al. “DSIP in the treatment of withdrawal syndromes from alcohol and opiates.” Eur Neurol. 1984;23(4):291-296. PubMed
  6. Kato N, et al. “DSIP-like material in rat brain, human cerebrospinal fluid and plasma as determined by enzyme immunoassay.” Neuropeptides.1984;4(4):253-261.
  7. Schneider-Helmert D. “DSIP in insomnia.” Eur Neurol.1984;23(4):245-252. PubMed
  8. Yehuda S, Carasso RL. “DSIP — a tool for investigating the sleep onset mechanism: a review.” Int J Neurosci. 1988;38(3-4):345-353. PubMed
  9. Iyer KS, et al. “DSIP — a neuropeptide with pleiotropic activity.” Gen Pharmacol. 1988;19(5):613-620.
  10. Lysenko AV, Uskova NI. “Mechanisms of DSIP antioxidant effect.” Bull Exp Biol Med. 2003;136(5):465-467.
  11. Khvatova EM, et al. “Delta sleep-inducing peptide (DSIP): effect on respiration in brain mitochondria and on oxidative stress under conditions of intermittent normoxia/hypoxia.” Bull Exp Biol Med.2003;136(5):467-470.

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