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Effect of growth hormone treatment on sleep EEGs in growth hormone-deficient children
1Department of Pediatrics, Bronx Lebanon Hospital Center, New York 10457.
Insights
Growth hormone deficiency (GHD) in children is linked to abnormal sleep patterns, particularly increased stage 3 sleep. Growth hormone (GH) therapy partially corrects this specific sleep anomaly.
Area of Science:
- Pediatric Endocrinology
- Sleep Medicine
- Neuroendocrinology
Background:
- Growth hormone deficiency (GHD) can impact various physiological processes.
- Sleep disturbances are increasingly recognized in children with endocrine disorders.
- Previous research indicates altered sleep architecture in GHD, but specific changes require further elucidation.
Purpose of the Study:
- To investigate the effects of growth hormone (GH) therapy on sleep parameters in children with GHD.
- To identify specific sleep EEG anomalies associated with GHD and their response to GH treatment.
Main Methods:
- Polysomnography was used to analyze sleep stages in seven children with GHD.
- Sleep data (total sleep time, sleep stages 1-4, REM, REM latency, sleep efficiency) were collected before and after GH therapy.
- Statistical analysis was performed to compare sleep parameters pre- and post-treatment.
Main Results:
- Children with GHD exhibited higher percentages of stage 1 and stage 3 sleep, and less REM sleep compared to normal controls.
- GH therapy led to a significant decrease in the duration and percentage of stage 3 sleep (p < 0.025).
- No other significant alterations in sleep parameters were observed following GH therapy.
Conclusions:
- GHD is associated with a distinct sleep EEG anomaly, characterized by increased stage 3 sleep.
- GH therapy partially corrects this specific sleep anomaly in GHD children.
- These findings differ from studies in normal subjects, suggesting a unique impact of GHD on sleep architecture.
Abstract:
Total sleep time, sleep stages 1-4, REM, REM latency, and sleep efficiency were analyzed in seven children with growth hormone deficiency (GHD) before and after growth hormone (GH) therapy. Before GH therapy, GHD children spent 19.5% of their total sleep time in REM sleep, 9.7% in stage 1, 41.0% in stage 2, 10.0% in stage 3, and 19.7% in stage 4. GHD children had more stage 1 and 3 sleep and less REM as compared with age-matched normal children reported by Williams et al. After GH therapy was initiated, six of the seven patients had decreases in the duration of stage 3 sleep, with an average decrease of 21.8 min. The difference between stage 3 sleep before and during GH treatment was significant, with a p value of less than 0.025. When the results were expressed as the percentage of the total sleep period, the difference was also significant, (10.0 +/- 2.0 to 7.5 +/- 3.1%, mean +/- SD; p less than 0.05). No other sleep parameters were significantly affected by GH therapy. The changes observed in stage 3 sleep, non-REM sleep, and the lack of any other changes in sleep before and after GH therapy have not been described before in GH-deficient children. They differ from studies in normal humans and animals which showed that REM sleep increased with administration of growth hormone. These differences suggest that GH deficiency is associated with a specific sleep EEG anomaly that is corrected in part by GH therapy.
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