Sleep apnoea and quality of life in growth hormone (GH)‐deficient adults before and after 6 months of GH replacement therapy

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Abstract
Summary: Objective  To investigate the sleep architecture and breathing as well as quality of life (QoL) in adults with GH deficiency (GHD) before and 6 months after GH replacement therapy.Design  A prospective observational study.Patients  Nineteen consecutive adults with GHD (11 men, eight women; mean age 53, range 21–73 years) were studied.Measurements  An overnight sleep study was performed and the Minor Symptom Evaluation Profile (MSEP), Functional Outcome of Sleep Questionnaire (FOSQ), Short Form 36 (SF‐36) and Epworth Sleepiness Scale (ESS) questionnaires were applied at baseline and after the treatment period.Results  For the whole group, there were no significant changes in mean total sleep time (TST; 370 min vs. 374 min), proportion of slow‐wave sleep (SWS; 17·8%vs. 18·4%) and rapid eye movement (REM) sleep (12·1%vs. 13·9%) on GH replacement. Mean apnoea–hypopnoea index (AHI) was high and remained unchanged (28·2/h before vs. 28·0/h following GH replacement). Twelve patients (63%) were found to have obstructive sleep apnoea (OSA; AHI ≥ 10/h) at baseline. Compared with GH‐deficient patients without OSA (AHI 3·9/h), the OSA patients (AHI 42·4/h) had less SWS (11·4%vs. 28·6%, P = 0·010) and REM sleep (10·1%vs. 15·5%, P = 0·036). A marginal increase was observed in REM sleep time (10·1% before vs. 12·7% after GH; P = 0·048) while SWS was unchanged in this group. Moreover, MSEP for General Well‐being and Responsiveness, FOSQ scores for General Productivity, Activity Level and Vigilance as well as SF‐36 domains for Vitality and Mental Health were improved.Conclusions  Contrary to some previous observations in a smaller group of patients, our data suggest that GH therapy does not induce or aggravate OSA in GH‐deficient adults. Moreover, GH therapy may improve some of the QoL dimensions in these patients.