I'm wondering if I had a similar problem. I was stressed and had sleep issues before getting my bloodwork done. I suspected PCOS due to facial hair (although mild hirsutism runs in my family, so they thought it's nothing). When I had my cortisol tested for the first time, it was in the higher end of normal, the same goes for DHEA-S. DHEA-S was only a bit too high when I went overboard with exercising (I wouldn't call that exercise per se, but I was "too" active and my body wasn't accustomed to it). No idea what was happening to my cortisol, though. Apparently, ACTH influences both cortisol and DHEA-S production, ACTH rises during stress. So stress and sleep issues alone (unless the lack of sleep is chronic maybe, not just not getting enough sleep for 2 days?) can't push my DHEA-S above the reference range. I wasn't diagnosed with PCOS (no polycystic ovaries, regular periods) and the facial hair stayed the same for 2 years (DHEA-S was elevated for a short time, it seems, maybe it didn't do anything). The thing is when my facial hair grew I had a stressful period of time at a university. I didn't get enough sleep, was stressed and drank lots of coffee. Maybe that coffee did something, but then I stopped drinking so much of it, so I didn't get symptoms?