Sleep disturbances in patients with Addison's disease.
OBJECTIVE
The standard replacement therapy in Addison's disease does not restore normal nocturnal levels of the hormones of the hypothalamic-pituitary-adrenal axis. The aim of the study was to describe the prevalence and characteristics of sleep disturbances in patients with Addison's disease.


METHODS
Sixty patients completed a self-administered sleep questionnaire and the Epworth Sleepiness Scale (ESS) questionnaire. Activity-based monitoring (actigraph recordings) and sleep diaries were obtained from eight patients.


RESULTS
Thirty-four percent reported weekly sleep disturbances (difficulties falling asleep in 13%; repeated awakenings in 14%; early morning awakenings in 20%). The sleep need was 8.21 h (s.d. 1.34; range 6-14 h), and sleep onset latency was 29 min (s.d. 29, range 2-150 min). Forty percent of the patients were tired during daily activities more than once a week, but the scores of the ESS were 6.0 (s.d. 3.5), which is not higher than normal. The actigraph recordings showed higher sleep efficiency than the subjective recordings.


CONCLUSIONS
We did not identify specific sleep disturbances which were characteristic for patients with Addison's disease. Patients with Addison's disease have increased daytime fatigue, but no more daytime sleepiness than normal.
Løvås
Kristian
K
Institute of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway. kristian.lovas@haukeland.no
Husebye
Eystein S
ES
Holsten
Fred
F
Bjorvatn
Bjørn
B
D000224:Addison Disease / Q000150:complications*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002940:Circadian Rhythm; D005221:Fatigue; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires
D006854:Hydrocortisone