Sleep Disturbances, Daytime Sleepiness, and Quality of Life in Adults with Growth Hormone Deficiency
Sleep Disturbances, Daytime Sleepiness, and Quality of Life in Adults with Growth Hormone Deficiency
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DOI：
10.1210/jc.2009-2080
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发表时间：
2010-05-01
影响因子：
5.8
通讯作者：
Van Cauter, Eve
中科院分区：
文献类型：
--
作者：
Copinschi, Georges;Nedeltcheva, Arlet;Van Cauter, Eve
背景：低能量和疲劳是GH缺乏症（GHD）受试者的常见主诉。由于睡眠和生长激素调节之间的相互关系是有据可查的，这些投诉可能部分反映了睡眠质量的改变。目的：本研究的目的是确定成人GHD患者的客观和主观睡眠质量和白天嗜睡。30例患者，年龄19 - 74岁，患有未经治疗的GHD（26例患者证实或可能有原发性垂体缺陷，4例患者有下丘脑起源），30名性别、年龄和体重指数匹配的健康对照者参加了这项研究。与垂体缺陷相关的患者（n = 28）接受激素替代治疗。方法：多导睡眠记录，匹兹堡睡眠质量指数评估，生活质量评估成人GHD。结果：不管病因如何，GHD患者的匹兹堡睡眠质量指数评分高于睡眠质量差的临床临界值，而成人GHD生活质量评估评分低于控制，疲劳是最受影响的领域。垂体性GHD患者的慢波睡眠（SWS）时间更长，SWS强度更高。在这些患者中，老年人的总睡眠时间比对照组少，他们的晚睡眠更分散。对比垂体GHD，4例下丘脑GHD患者的SWS强度较低，比他们的controls.Conclusions：GHD与睡眠障碍，可能是由特定的激素改变，以及与主观睡眠质量差，白天嗜睡。睡眠紊乱可能是导致疲劳增加的部分原因，疲劳是GHD生活质量的主要组成部分。（临床内分泌代谢杂志95：2195 - 2202，2010）
Context: Low energy and fatigue are frequent complaints in subjects with GH deficiency (GHD). Because interrelations between sleep and GH regulation are well documented, these complaints could partly reflect alterations of sleep quality.Objective: The objective of the study was to determine objective and subjective sleep quality and daytime sleepiness in adult GHD patients.Subjects: Thirty patients, aged 19-74 yr, with untreated GHD (primary pituitary defects confirmed or likely in 26 patients, hypothalamic origin in four patients), and 30 healthy controls individually matched for gender, age, and body mass index participated in the study. Patients with associated pituitary deficiencies (n = 28) were on hormonal replacement therapy.Methods: Polygraphic sleep recordings, assessment of Pittsburgh Sleep Quality Index, and Quality of Life Assessment for GHD in Adults were measured.Results: Irrespective of etiology, GHD patients had a Pittsburgh Sleep Quality Index score above the clinical cutoff for poor sleep and lower Quality of Life Assessment for GHD in Adults scores than controls, with tiredness being the most affected domain. Patients with pituitary GHD spent more time in slow-wave sleep (SWS) and had a higher intensity of SWS than their controls. Among these patients, older individuals obtained less total sleep than controls, and their late sleep was more fragmented. Contrasting with pituitary GHD, the four patients with hypothalamic GHD had lower intensity of SWS than their controls.Conclusions: GHD is associated with sleep disorders that may be caused by specific hormonal alterations as well as with poor subjective sleep quality and daytime sleepiness. Disturbed sleep is likely to be partly responsible for increased tiredness, a major component of quality of life in GHD. (J Clin Endocrinol Metab 95: 2195-2202, 2010)