Endocrine Abstracts

Introduction

The Epworth Sleepiness Scale (ESS) is a validated simple method of measuring subjective daytime sleepiness in a variety of situations whereby patients are asked to score the probability of dozing as no chance, slight, moderate or high chance. An ESS>10 is regarded as excessive daytime sleepiness which may be a result of sleep apnoea or sleep disorders. The British Thoracic Society advise that patients who have ESS>10 or sleepiness in dangerous situations and symptoms of sleep apnoea should be referred for sleep studies.

Aim

To assess the daytime sleepiness in patients with a diagnosis of Acromegaly.

Method

43 patients with a diagnosis of Acromegaly were identified from the clinic database. Patients were asked to complete an Epworth Sleepiness Scale questionnaire. 81% (35/43) answered the questionnaire. Demographics:17 males, 18 females; Age range: 26–79 years old (median age 61). Random GH, mean GH on latest OGTT and IGF-1 levels were obtained from computer records. Satisfactory GH levels were defined as either random GH<1 mU/l or mean GH on OGTT <5 mU/l consistent with remission.

Results

54.2% of patients (19/35) had an ESS>10. 52.6% of patients (10/19) scoring >10 had GH and IGF-1 consistent with remission. 3 patients had a confirmed diagnosis of sleep apnoea, whilst 3 were awaiting sleep study investigation.

Conclusion

54.2% of the acromegalic population studied reported excessive daytime sleepiness. This compares with surveys performed in Switzerland and Japan on the normal background population which found ESS>10 in 13% and 9.6% of respondents respectively. Possible factors contributing to daytime sleepiness in patients with Acromegaly include sleep apnoea (obstructive or central), sleep disorders or suboptimal hormone replacement. There is potential to improve quality of life in these patients by optimising hormone replacement and considering investigation with sleep studies to identify treatable conditions.