Sleep Disturbances in Patients With Cushing Syndrome and Mild Autonomous Cortisol Secretion: A Cross-sectional Study

Area of Science:

• Endocrinology
• Sleep Medicine
• Clinical Research

Background:

• The impact of hypercortisolism on sleep is not fully understood.
• Cushing syndrome (CS) is associated with impaired sleep.
• Mild autonomous cortisol secretion (MACS) involves mild nocturnal hypercortisolism that may affect sleep.

Purpose of the Study:

• To assess sleep abnormalities in patients with CS and MACS using the Pittsburgh Sleep Quality Index (PSQI).
• To identify factors linked to poor sleep in these patient groups.
• To compare sleep issues in MACS patients with referent subjects.

Main Methods:

• A single-center cross-sectional study involving adults with active CS and MACS.
• Assessment of sleep quality using the PSQI.
• Calculation of clinical and biochemical hypercortisolism severity scores.

Main Results:

• Patients with MACS showed significantly poorer sleep quality, shorter sleep duration, longer sleep latency, and increased daytime dysfunction compared to referents.
• No significant differences in PSQI scores were found between CS and MACS patients after adjusting for age, sex, and BMI.
• In MACS patients, younger age, female sex, and higher clinical severity scores correlated with impaired sleep.

Conclusions:

• Sleep impairment is evident in patients with MACS, comparable to that seen in CS.
• Younger women with more severe clinical manifestations of MACS are at higher risk for sleep disturbances.