Sleep and Quality of Life in Endocrine Diseases

SummaryIt is well established that a close relationship exists between sleep and hormones of the hypothalamic–pituitaryaxis. Sleep has an electrophysiological component and an endocrine component, i.e., the distinct patterns ofhormone secretion. Both the electrophysiological and the hormonal component interact bidirectional.Sleependocrinerhythms are closely interrelated, and sleep is an important regulator of (neuro)endocrine function. Thesecretion of growth hormone (GH), prolactin (PRL), and thyrotropin (TSH) is markedly increased during sleep,whereas the secretion of adrenocorticotrophic hormone (ACTH) and cortisol is inhibited. Sleep deprivation isassociated with decreased GH and PRL secretion, and increased cortisol and TSH secretion. The decrease of GHsecretion, which occurs with advancing age, is strongly associated with impaired quality of sleep. Increasing ageis associated with increased levels of cortisol, which is significant after age 50 years when sleep is morefragmented and REM sleep declines. GH deficiency in adults (AGHD) is a wellrecognizedclinical syndrome,which is characterized by abnormal body composition and most notably, impairment of quality of life (QoL).Recent studies on longtermtreatment of adult GHdeficientpatients have convincingly shown that GHreplacement therapy improves QoL in association with a reduction in healthcare utilization. Chronic excess ofglucocorticoids, Cushing’s syndrome, is associated with sleep disturbances, mood alterations, depression, andimpaired QoL. Patients with thyroid disease have sleep disturbances and a significantly reduced healthrelatedQo