Somatostatin analog treatment is associated with an increased sleep latency in patients with long-term biochemical remission of acromegaly.
BACKGROUND
Somatostatin analogs induce alterations in sleep in healthy adults. Presently, it is unknown whether somatostatin analog treatment affects sleep parameters in patients with acromegaly.


METHODS
Case-control study.


METHODS
We assessed sleepiness and sleep patterns in 62 adult patients (32 men, age 61 years (33-88 years) controlled by surgery alone or postoperative radiotherapy (69%), and/or somatostatin analogs (31%). We used two validated sleep questionnaires (Epworth sleepiness score and Münchener chronotype questionnaire). Patient outcomes were compared to controls.


RESULTS
Sleep duration and timing of sleep were not different in patients compared to controls. However, sleepiness score was increased in all patients compared to controls: 6 (1-20) vs. 4 (0-14), P=0.014 (median (range)), reflecting increased daytime sleepiness. Snoring was reported in 68% of both patients and controls (P=0.996), observed apnoea's and restless legs in 23% and 37% of patients compared to 12% and 21% of controls (P=0.062 and P=0.031, resp.). In addition, sleep latency was increased in patients treated by somatostatin analogs compared to patients cured by surgery and/ or radiotherapy (52+/-48 min vs. 26+/-40 min, P=0.005), resulting in a delayed sleep onset (24:08+/-1:26 h vs. 23:25+/-0:43 h, P=0.053). Sleep duration was unaffected.


CONCLUSIONS
Daytime sleepiness is increased in a homogeneous cohort of patients in long-term remission from acromegaly. In addition, somatostatin analog treatment increases sleep latency and delays sleep onset in patients with long-term biochemical control of growth hormone overproduction without altering total sleep duration.
Klaauw
Agatha A van der
AAV
Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
Pereira
Alberto M
AM
Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
Kralingen
Klaas W van
KWV
Department of Pulmonology, Leiden University Medical Center, The Netherlands.
Rabe
Klaus F
KF
Department of Pulmonology, Leiden University Medical Center, The Netherlands.
Romijn
Johannes A
JA
Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
D000172:Acromegaly / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000378:metabolism; D005260:Female; D019382:Human Growth Hormone / Q000096:biosynthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012890:Sleep / Q000187:drug effects*; D012893:Sleep Wake Disorders / Q000209:etiology; D013004:Somatostatin / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011795:Surveys and Questionnaires
D019382:Human Growth Hormone; D013004:Somatostatin