Cushing's syndrome is associated with sleep alterations detected by wrist actigraphy
Cushing's syndrome is associated with sleep alterations detected by wrist actigraphy
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DOI：
10.1007/s11102-015-0667-0
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发表时间：
2015-12-01
期刊：
影响因子：
3.8
通讯作者：
Arvat, Emanuela
中科院分区：
文献类型：
--
作者：
D'Angelo, Valentina;Beccuti, Guglielmo;Arvat, Emanuela
背景 下丘脑-垂体-肾上腺 (HPA) 轴与睡眠之间的关联已得到充分描述。众所周知，HPA 轴紊乱也会影响睡眠。事实上，库欣综合征（CS）患者经常抱怨睡眠质量差。我们的目的是使用腕部活动记录仪评估活跃期库欣综合征患者的客观睡眠质量和持续时间。 患者和方法 12 名未接受持续特异性治疗的活动性 CS 患者（11 F，1 M；年龄 40.0 +/- A 10.9 岁；BMI 28.4 +/- A 6.7 kg/m(2)）和 12 名健康对照受试者 (HS)（11 F，1 M；年龄 44.0） +/- A 11.0 岁；BMI 23.9 +/- A 4.2 kg/m(2)) 在自由生活条件下连续 3 天进行体动记录评估。睡眠持续时间和质量的客观测量通过 actiwatch 进行评估，actiwatch 是一种类似手表的设备，用于检测运动活动。 结果 在 CS 患者中，腕部体动记录仪显示较高的碎片化睡眠（碎片化指数 CS 16.2 +/- A 4.2、HS 13.0 +/- A 3.6；p = 0.034）和夜间运动活动增加（总活动评分 CS 8318 +/- A 4308， HS 4971 +/- A 2372；p = 0.020；平均活动分数 CS 8.7 +/- A 4.2，HS 5.4 +/- A 2.2；p = 0.030；活动时间平均分数 CS 104.8 +/- A 39.2，HS 74.8 +/- A 23.1；p = 0.030。相反，CS 和 HS 的实际睡眠时间结果相似。患者的睡眠改变和尿游离皮质醇之间没有发现相关性。结论我们研究中描述的体动记录参数受损表明皮质醇增多症与睡眠改变有关，这可能导致生活质量恶化和与 CS 相关的代谢合并症。这些结果必须在更大的患者群体中得到证实，并使用更准确的睡眠评估仪器。
Background The association between the hypothalamic-pituitary-adrenal (HPA) axis and sleep is well described. It is also known that HPA axis disturbances have an effect on sleep. In fact, patients affected by Cushing's syndrome (CS) often complain about poor sleep quality. Our aim was to evaluate objective sleep quality and duration in patients with Cushing's syndrome in active phase, using wrist actigraphy.Patients and methods In 12 patients with active CS without ongoing specific therapy (11 F, 1 M; age 40.0 +/- A 10.9 years; BMI 28.4 +/- A 6.7 kg/m(2)) and 12 healthy control subjects (HS) (11 F, 1 M; age 44.0 +/- A 11.0 years; BMI 23.9 +/- A 4.2 kg/m(2)) an actigraphic evaluation was performed on 3 consecutive days under free living conditions. Objective measurement of sleep duration and quality was estimated by an actiwatch, which is a wristwatch-like device used to detect motor activity.Results In CS patients, wrist actigraphy showed higher fragmented sleep (fragmentation index CS 16.2 +/- A 4.2, HS 13.0 +/- A 3.6; p = 0.034) and increased nocturnal motor activity (total activity score CS 8318 +/- A 4308, HS 4971 +/- A 2372; p = 0.020; mean activity score CS 8.7 +/- A 4.2, HS 5.4 +/- A 2.2; p = 0.030; mean score in active time CS 104.8 +/- A 39.2, HS 74.8 +/- A 23.1; p = 0.030). On the contrary, actual sleep time resulted similar in CS and HS. No correlation was found between sleep alterations and urinary free cortisol in patients.Conclusions The impaired actigraphic parameters described in our study suggest that hypercortisolism is associated with sleep alterations, which could contribute to the worsening of life quality and metabolic comorbidities associated with CS. These results have to be confirmed in a larger cohort of patients, using more accurate instruments for sleep assessment.