Addison's Disease Research Today is a free monthly online journal that collates and summarizes the latest research about Addison's Disease, including details on chronic adrenal insufficiency, treatment, causes, medication.

Sleep improvement in an insomniac patient with global pituitary insufficiency after change from triple to quadruple cortisol replacement therapy.

Voss U, Tuin I, Krakow K

Department of Psychology, J.W. Goethe-University Frankfurt/M, Germany. voss@psych.uni-frankfurt.de

Although cortisol has a distinct circadian rhythm, patients with adrenal insufficiency usually receive diurnal hydrocortisone replacement therapy (HRT), disregarding possible consequences for sleep quality. The case reported here concerns the resolution of severe insomnia in a patient with global hypopituitary insufficiency upon adjustment of triple HRT to quadruple HRT. The data show a strong influence of cortisol on total sleep time and slow wave sleep (SWS) as well as rapid eye movement (REM) sleep. Clinically, the data are suggestive of the need to assimilate HRT to the natural circadian cortisol rhythm and not restrict it to the active part of the day.

Published 2 July 2007 in Sleep Med, 8(5): 517-9.
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