MACS patients suffer sleep impairment similar to those with Cushing syndrome

Patients with mild autonomous cortisol secretion (MACS) may experience poor sleep quality comparable to those with Cushing syndrome (CS), reports a study. Notably, sleep impairment appears to be more common among younger women with higher clinical MACS severity.

This single-centre, cross-sectional study included 194 adults with active CS (mean Pittsburgh Sleep Quality Index [PSQI] 12) and 194 with MACS (mean PSQI 11). PSQI was used to assess sleep quality.

The researchers calculated clinical and biochemical scores for hypercortisolism among patients and enrolled 89 referent participants (mean PSQI 5). They also assessed quality of life (QoL) using the Short Form-36 (SF-36) in all participants and the CushingQoL in those with active hypercortisolism.

Patients with MACS had shorter sleep duration, longer sleep latency, more severe daytime dysfunction, lower sleep efficiency, and a higher sleep medication use than referent participants (p<0.001 for all). Analysis adjusted for age, sex, and BMI revealed no differences in PSQI or its subcomponents between patients with CS and those with MACS (p>0.04 for all).

In multivariate analysis, factors such as younger age, female sex, and higher clinical hypercortisolism severity score significantly correlated with sleep impairment. Among patients with CS, only younger age remained significantly associated with poor sleep.

“Patients with MACS demonstrate sleep impairment that is similar to patients with CS,” the researchers said. “Younger women with higher clinical severity of MACS are more likely to have impaired sleep.”