Clinical endocrinology · 2011
Compression of the optic chiasm is associated with permanent shorter sleep duration in patients with pituitary insufficiency.
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Borgers Anke J, Romeijn Nico, van Someren Eus, Fliers Eric, Alkemade Anneke, Bisschop Peter H
Аннотация
OBJECTIVE: Patients with pituitary insufficiency often experience some degree of impaired sleep. Sleep-wake rhythm is regulated to a large extent by the suprachiasmatic nucleus (SCN). Because the SCN is located just superior to the optic chiasm, we hypothesized that a history of compression of the optic chiasm (CC) due to a tumour with suprasellar extension is associated with altered sleep patterns in patients with pituitary insufficiency.
DESIGN: Case-control study.
PATIENTS: We studied 38 patients (mean age 55·7 ± 13·1 years; 71·1% men) with CC and 18 patients (mean age 53·3 ± 16·6 years, 38·9% men) without CC.
MEASUREMENTS: Objective measures of sleep patterns were assessed by wrist actigraphy. Validated sleep questionnaires were used to evaluate subjective sleep parameters.
RESULTS: Objective total sleep duration was 36 min shorter in patients with CC than in patients without CC [454 (295-553) vs 490 (432-740) min, P = 0·034]. Moreover, patients with CC had a later habitual bedtime [23:15 (22:30-03:00) vs 22:55 (20:00-02:00) h, P = 0·044] and a later actigraphic sleep onset [23:57 (22:31-01:33) vs 23·16 (19:47-03:04) h, P = 0·020]. Linear regression analysis confirmed the difference in total sleep duration after adjustment for age, sex, body mass index, cranial radiotherapy and pituitary/hypothalamic surgery. Subjective sleep parameters were similar in both groups.
CONCLUSIONS: Compression of the optic chiasm due to a tumour with suprasellar extension is associated with permanent changes in total sleep duration in patients with pituitary insufficiency.
DESIGN: Case-control study.
PATIENTS: We studied 38 patients (mean age 55·7 ± 13·1 years; 71·1% men) with CC and 18 patients (mean age 53·3 ± 16·6 years, 38·9% men) without CC.
MEASUREMENTS: Objective measures of sleep patterns were assessed by wrist actigraphy. Validated sleep questionnaires were used to evaluate subjective sleep parameters.
RESULTS: Objective total sleep duration was 36 min shorter in patients with CC than in patients without CC [454 (295-553) vs 490 (432-740) min, P = 0·034]. Moreover, patients with CC had a later habitual bedtime [23:15 (22:30-03:00) vs 22:55 (20:00-02:00) h, P = 0·044] and a later actigraphic sleep onset [23:57 (22:31-01:33) vs 23·16 (19:47-03:04) h, P = 0·020]. Linear regression analysis confirmed the difference in total sleep duration after adjustment for age, sex, body mass index, cranial radiotherapy and pituitary/hypothalamic surgery. Subjective sleep parameters were similar in both groups.
CONCLUSIONS: Compression of the optic chiasm due to a tumour with suprasellar extension is associated with permanent changes in total sleep duration in patients with pituitary insufficiency.