Sleep Disruption Common to Both Cushing Syndrome and Mild Autonomous Cortisol Secretion, Study Finds
new research reveals patients with Cushing syndrome and mild autonomous cortisol secretion (MACS) experience comparable levels of sleep impairment, with younger age emerging as a key factor linked to poorer sleep quality in both conditions. The findings, published recently, underscore the significant impact of cortisol dysregulation on sleep and highlight the need for targeted interventions to improve sleep health in these patient populations.
Both Cushing syndrome – a hormonal disorder caused by prolonged exposure to high levels of cortisol – and MACS, a milder form of cortisol excess, are increasingly recognized as contributors to diminished quality of life. This study confirms that sleep disturbance is a pervasive symptom in both, potentially exacerbating other health issues. Understanding the specific factors influencing sleep in these conditions is crucial for developing effective management strategies and improving patient outcomes. Researchers found that,compared to control individuals,those with MACS and Cushing syndrome both exhibited significantly worse scores on the short Form 36 (SF-36) health survey (all P* < .001). Patients with Cushing syndrome demonstrated even greater impairment than those with MACS across most SF-36 measures (all *P ≤ .004), with the exception of emotional limitations (P* = .002).
The study also revealed significant correlations between sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), and various measures of physical and mental well-being. In both Cushing syndrome and MACS, higher PSQI scores (indicating poorer sleep) were linked to lower scores on SF-36 mental and physical component scores, and also Cushing Quality of Life (CushingQoL) assessments (r range, -0.56 to -0.40; all *P < .001). Notably,clinical severity was correlated with PSQI scores onyl in MACS patients (r = 0.17; P* = .020).
Further analysis identified specific factors associated with sleep quality. Among control individuals, increased BMI was linked to worse sleep (b = 0.21; *P = .005). In Cushing syndrome, sleep quality worsened with younger age (b = -0.12; P* < .001), while in MACS, sleep was negatively impacted by increasing age (b = -0.08; *P = .009), higher clinical severity (b = 0.14; P* =.044), and female gender (b = 2.35; *P = .002).
The researchers acknowledged the study’s limitation of relying on self-reported sleep data, noting the absence of objective sleep measurements. They concluded that ”patients with MACS and [Cushing syndrome] demonstrate similar sleep impairment,” and that “younger age, female sex and higher clinical severity score were associated with worse sleep in patients with MACS, while younger age was the only factor associated with poor sleep in patients with [cushing syndrome].”
Disclosure: Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
