Objectives

Our aim was to investigate the effects of endogenous chronic hypercortisolism on sleep electroencephalogram (EEG) and differences between the adrenocorticotropic hormone (ACTH)-dependent and independent Cushing Syndrome (CS) patients through a sleep spectral analysis program.

Methods

A total of 32 patients diagnosed as having endogenous CS (12 ACTH-dependent and 20 ACTH-independent) and a control group comprising 16 healthy individuals were included in the study. Polysomnographic analysis was performed. Blood samples were collected at 08:00 AM for analysis of ACTH and basal cortisol, and at 00:00 AM for midnight cortisol levels. The frequency and power of the slow wave activity (SWA), theta, alpha, and beta waves of the first and last non-rapid eye movement (NREM) cycles were measured with a spectral analysis program.

Results

The CS patient group had higher SWA power, especially in the first NREM cycle. In the ACTH-dependent group, SWA maximum and mean power values were higher in the frontal channels in the first NREM, compared to the last NREM sleep stage (p<0.05).

Conclusion

Cortisol has been found to be associated with SWA waves, making these waves higher in power, especially in the first NREM phase. This difference was much less pronounced in the final NREM sleep stage. The difference between the first and last NREM sleep stages with respect to the power of SWA in the frontal channel in the ACTH-dependent group suggests that not only cortisol but also high levels of ACTH affect the power of slow waves during sleep.

中文翻译：

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皮质醇增多症对库欣综合征患者睡眠脑电波频率和幅度的影响：频谱分析研究

目标

我们的目的是通过睡眠频谱分析程序研究内源性慢性皮质醇增多症对睡眠脑电图（EEG）的影响以及促肾上腺皮质激素（ACTH）依赖性和独立性库欣综合征（CS）患者之间的差异。

方法

该研究共纳入了 32 名被诊断患有内源性 CS 的患者（12 名 ACTH 依赖性患者和 20 名 ACTH 非依赖性患者）和由 16 名健康个体组成的对照组。进行多导睡眠图分析。上午 08:00 采集血样以分析 ACTH 和基础皮质醇，并于上午 00:00 采集血样分析午夜皮质醇水平。使用频谱分析程序测量第一个和最后一个非快速眼动 (NREM) 周期的慢波活动 (SWA)、θ、α 和 β 波的频率和功率。

结果

CS 患者组具有较高的 SWA 功率，尤其是在第一个 NREM 周期中。在 ACTH 依赖组中，与最后一个 NREM 睡眠阶段相比，第一个 NREM 睡眠阶段额叶通道中的 SWA 最大功率和平均功率值较高（p <0.05）。

结论

研究发现皮质醇与 SWA 波相关，使这些波的功率更高，尤其是在第一个 NREM 阶段。这种差异在 NREM 睡眠的最后阶段不太明显。在 ACTH 依赖组中，第一个和最后一个 NREM 睡眠阶段相对于额叶通道中 SWA 功率的差异表明，不仅皮质醇而且高水平的 ACTH 都会影响睡眠期间慢波的功率。