title: Impact of GH replacement therapy on sleep in adult patients with GH deficiency of pituitary origin.
abstract: OBJECTIVE
  We previously reported that adult patients with GH deficiency (GHD) due to a confirmed or likely pituitary defect, compared with healthy controls individually matched for age, gender, and BMI, have more slow-wave sleep (SWS) and higher delta activity (a marker of SWS intensity). Here, we examined the impact of recombinant human GH (rhGH) therapy, compared with placebo, on objective sleep quality in a subset of patients from the same cohort.
  
  
  METHODS
  Single-blind, randomized, crossover design study.
  
  
  METHODS
  Fourteen patients with untreated GHD of confirmed or likely pituitary origin, aged 22-74 years, participated in the study. Patients with associated hormonal deficiencies were on appropriate replacement therapy. Polygraphic sleep recordings, with bedtimes individually tailored to habitual sleep times, were performed after 4 months on rhGH or placebo.
  
  
  RESULTS
  Valid data were obtained in 13 patients. At the end of the rhGH treatment period, patients had a shorter sleep period time than at the end of the placebo period (479±11 vs 431±19 min respectively; P=0.005), primarily due to an earlier wake-up time, and a decrease in the intensity of SWS (delta activity) (559±125 vs 794±219 μV(2) respectively; P=0.048).
  
  
  CONCLUSIONS
  Four months of rhGH replacement therapy partly reversed sleep disturbances previously observed in untreated patients. The decrease in delta activity associated with rhGH treatment adds further evidence to the hypothesis that the excess of high-intensity SWS observed in untreated pituitary GHD patients is likely to result from overactivity of the hypothalamic GHRH system due to the lack of negative feedback inhibition by GH.
authors: Department of Medicine, Sleep, Metabolism and Health Center (SMAHC), University of Chicago, Chicago, Illinois 60637, USA. lmorsell@medicine.bsd.uchicago.edu
authors: Lisa L
authors: LL
authors: Morselli
authors: Arlet
authors: A
authors: Nedeltcheva
authors: Rachel
authors: R
authors: Leproult
authors: Karine
authors: K
authors: Spiegel
authors: Enio
authors: E
authors: Martino
authors: Jean-Jacques
authors: JJ
authors: Legros
authors: Roy E
authors: RE
authors: Weiss
authors: Jean
authors: J
authors: Mockel
authors: Eve
authors: E
authors: Van Cauter
authors: Georges
authors: G
authors: Copinschi
mesh_terms: D000328:Adult; D000368:Aged; D058256:Brain Waves / Q000187:drug effects*; D002540:Cerebral Cortex / Q000187:drug effects*; D018592:Cross-Over Studies; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D016037:Single-Blind Method; D012890:Sleep / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D019382:Human Growth Hormone