Exp Clin Endocrinol Diabetes 2013; 121 - OP8_50
DOI: 10.1055/s-0033-1336659

Sleep quality in patients with primary aldosteronism

FM Hanusch 1, E Fischer 2, K Lang 3, S Diederich 4, S Endres 2, B Allolio 3, F Beuschlein 2, M Reincke 2 M Quinkler 1, for the participants of the German Conn's Registry
  • 1Charité, Klinische Endokrinologie, Berlin, Germany
  • 2Medizinische Klinik-Innenstadt, University Hospital Munich, Department of Endocrinology and Metabolism, Munich, Germany
  • 3University Hospital of Wuerzburg, Endocrinology & Diabetes Unit, Department of Internal Medicine I, Wuerzburg, Germany
  • 4ENDOKRINOLOGIKUM Berlin, Berlin, Germany

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

Patients and methods: This prospective multi-center study included 15 patients with newly diagnosed PA evaluated before and one year after treatment initiation, and a second cohort including 82 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), Pittsburgh Sleep Quality-Index (PSQI)) were analyzed.

Results: Exhaustion tendency (GBB) significantly improved in newly diagnosed PA patients after treatment initiation ((10.9 ± 8.0 vs. 5.7 ± 5.3). In the second cohort no differences were found in GBB-24, ESS and PSQI. No differences were found in all three questionnaires depending on type of PA therapy. However, PSQI showed a significant worse outcome (p < 0.005) in female than in male patients (8.7 ± 3.6 vs. 5.7 ± 4.2), independent 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 significant more sleep disturbances than male PA patients several years after treatment initiation.