CLINICAL STUDY 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. Conclusion: 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. European Journal of Endocrinology 148 449–45