Sleep disorders and cognitive dysfunction in acromegaly

• Published in: Endocrine Vol. 66; no. 3; pp. 634 - 641
• Main Authors: Wennberg, A., Lorusso, R., Dassie, F., Benavides-Varela, S., Parolin, M., De Carlo, E., Fallo, F., Mioni, R., Vettor, R., Semenza, C., Maffei, P.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2019; Springer Nature B.V
• Subjects: Acromegaly; Acromegaly - complications; Adult; Aged; Apnea; Cognition; Cognitive ability; Cognitive Dysfunction - etiology; Diabetes; Endocrinology; Female; Humanities and Social Sciences; Humans; Internal Medicine; Male; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Middle Aged; multidisciplinary; Original Article; Quality of life; Regression analysis; Science; Sleep; Sleep and wakefulness; Sleep disorders; Sleep Wake Disorders - complications; Acromegaly; Cognition; Sleep; Growth hormone; Quality of life
• ISSN: 1355-008X; 1559-0100; 1559-0100
• DOI: 10.1007/s12020-019-02061-1

Purpose In the general population, sleep disorders are associated with an increased risk of cognitive impairment. The prevalence of sleep disorders, such as sleep apnea, in acromegalic patients is higher than in the general population, and they may have additional risk of cognitive impairment due to acromegaly treatment and comorbidities. We aim to study the relationship between sleep disturbances and cognitive dysfunction in a group of acromegalic patients. Methods We studied 67 consecutive acromegalic patients. We performed a neurocognitive assessment and patients completed the Acromegaly Quality of Life Questionnaire (AcroQoL), Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index. Results Of the 67 acromegaly patients in the study, 38.8% were male and median age at the neurological examination was 56 (IQR 48, 65). Approximately 6–10% of patients had impaired cognitive assessment, depending on the test. In linear regression models adjusted for age, sex, BMI, disease duration, and disease activity, poorer sleep quality was associated with lower global cognitive z -score ( B  = −0.03, 95% CI −0.06, −0.002). Daytime somnolence was associated with poorer physical AcroQoL sub-score ( B  = −0.04, 95% CI −0.08, −0.002). Sleep quality was associated with poorer overall AcroQoL ( B  = −0.03, 95% CI −0.05, −0.006), physical AcroQoL ( B  = −0.04, 95% CI −0.07, −0.005), psychological AcroQoL ( B  = −0.02, 95% CI −0.04, −0.001), and social AcroQoL ( B  = −0.02, 95% CI −0.04, −0.0009). Conclusions In acromegaly patients, we found robust evidence that poor sleep quality is associated with poorer quality of life, and some evidence that it is associated with poorer cognitive function.