Sleep quality in patients with primary aldosteronism.
OBJECTIVE
In subjects at high risk for sleep apnea (SA), aldosterone concentrations correlate with severity of SA and primary aldosteronism (PA) is very often diagnosed. Patients with PA show a high prevalence of SA. Treatment of PA either by adrenalectomy (ADX) or mineralocorticoid receptor (MR) blockade is thought to abolish the increased comorbidities. However, no data are available regarding effectiveness of different PA treatments on quality of sleep.


METHODS
This prospective multi-center study included 15 patients with newly diagnosed PA evaluated before and 0.7 ± 0.2 years after treatment initiation, and a second cohort including 81 patients who were evaluated 5.3 and 6.8 years after treatment initiation. Biochemical parameters, 24h blood pressure and three validated self-assessment questionnaires (Giessen Complaint List (GBB-24), Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality-Index (PSQI)) were analyzed.


RESULTS
Z-scores of exhaustion tendency of GBB significantly improved in newly diagnosed PA patients after treatment initiation (1.8 ± 1.4 vs. 1.0 ± 1.2, p=0.034). In the second cohort no differences were found in GBB-24, ESS and PSQI. No differences were found in all three questionnaires independently of type of PA therapy. However, female patients scored significantly higher than males in the PSQI (8.7 ± 3.6 vs 5.7 ± 4.2, p<0.005), indicating lower sleep quality, independently of the type of therapy.


CONCLUSIONS
For the first time, we analyzed quality of sleep in patients with PA, demonstrating that therapy initiation improves exhaustion tendency. Surprisingly, female PA patients showed significantly more sleep disturbances than male PA patients several years after treatment initiation.
Clinical Endocrinology, Charit Campus Mitte, Charitί University Medicine Berlin, Germany.
Franziska M
FM
Hanusch
Department of Endocrinology and Metabolism, Medizinische Klinik-Innenstadt, University Hospital Munich, Germany.
Evelyn
E
Fischer
Endocrinology & Diabetes Unit, Department of Internal Medicine I, University Hospital of Wrzburg, Werzburg, Germany.
Katharina
K
Lang
Endokrinologikum, Berlin; Germany.
Sven
S
Diederich
Department of Endocrinology and Metabolism, Medizinische Klinik-Innenstadt, University Hospital Munich, Germany.
Stephan
S
Endres
Endocrinology & Diabetes Unit, Department of Internal Medicine I, University Hospital of Wrzburg, Werzburg, Germany.
Bruno
B
Allolio
Department of Endocrinology and Metabolism, Medizinische Klinik-Innenstadt, University Hospital Munich, Germany.
Felix
F
Beuschlein
Department of Endocrinology and Metabolism, Medizinische Klinik-Innenstadt, University Hospital Munich, Germany.
Martin
M
Reincke
Clinical Endocrinology, Charit Campus Mitte, Charitί University Medicine Berlin, Germany.
Marcus
M
Quinkler
D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012042:Registries; D012737:Sex Factors; D012890:Sleep / Q000187:drug effects / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
D000959:Antihypertensive Agents