Endocrine Abstracts

Introduction: Sleep disorders (SD) confer high cardiovascular risk (related to 52–70% of acute myocardial infarctions and strokes). Hypertension (HTN), diabetes (DM), weight gain, sleepiness, fatigue and depression have been correlated with obstructive sleep apnea (OSA). Patients with pituitary adenomas (PA) present with reported sleep dysfunction, fatigue and metabolic risk factors that may persist despite treatment

Aim: Assess the correlation between sleep disturbance (SD), depression, BMI, HTN, diabetes Mellitus (DM), pituitary deficiencies (PD), tumor size, diagnosis and risk of OSA for patients with PA.

Methods: A single institution, prospective assessment of patients presenting with PA using modified: Piper Fatigue Scale (PFS), Epworth Sleepiness scale (ESS), Beck Depression Inventory (BDI); Baseline BMI, tumor size (by MRI), HTN and DM assessed. The STOPBang Inventory was applied to stratify OSA risk. Diagnoses confirmed by biochemistry and/or histopathology. Statistical Analysis with PASW18.

Results: One hundred and fifty-seven patients (106F/51M; macroadenoma 74/micro 83) enrolled. Mean age 45 years, BMI 30.1 kg/m² (17.5%>35); DM 20% (18F/12M); HTN 44% (40F/29M) 43.9% (40F/29M); Acromegaly 10% (16), Cushing’s Disease (CD) 10%(16), NFA 40%(63), PRL 25%(39), RC 7%, other 7. Clinical Depression found in 36% of patients (mood disturbance 56%), SD 64% (ESS >10, PFS>2), and Pit Def >1–40%. Higher SD, BMI and depression were correlated (P=0.001) also BMI, DM and HTN (P=0.001). SD, HTN, DM, PD, tumor size, were not correlated. Patients with CD had more SD (P=0.01), depression (P=0.007), DM (P=0.001) and HTN (P=0.03). Risk of OSA in PA was 57% (90/157, high risk in 17%) with highest risk in presence of DM+HTN.

Conclusion: Sleep disturbance in patients with PA is correlated with depression, BMI>30 kg/m² and associated with a moderate to high risk of OSA, particularly in the presence of diabetes plus hypertension. Evaluation of SD at baseline is warranted along with further research into sleep dysfunction post treatment, particularly related to metabolic indices.