Sleep disturbances in primary aldosteronism are associated to depressive symptoms - Could specific mineralocorticoidreceptors be a common pathway?

Copyright © 2024. Published by Elsevier Ltd..

Symptoms of depression and anxiety are frequent in patients with primary aldosteronism (PA) and are supposed to be independent risk factors for cardiovascular diseases (CVD). As patients with PA have an increased cardiovascular risk compared to patients with essential hypertension, sleep disturbances, which often accompany depressive and anxiety symptoms, may be an additional contributor to the cardiometabolic consequences of PA. To clarify this possible link we investigated 132 patients with PA at baseline and after one year after initiation of treatment either by adrenalectomy (ADX) or mineralocorticoid-receptor-antagonist (MRA). Sleep disturbances and daytime sleepiness were assessed with Pittsburg sleep Inventory (PSQI) and Epworth sleepiness scale (ESS). Patients with PA showed pathological scores for sleep disturbances at baseline according to PSQI, with females being more affected (8.1 vs. 5.7 p < 0.001), which was significantly improved after initiation of specific treatment (p = 0.002). For ESS we found scores within the normal range, but higher than the general population, which significantly improved at follow-up (p < 0.001). The intensity of sleep disturbances was highly correlated with scores of anxiety and depression at baseline and follow-up. However, clinical and biochemical markers of PA (e.g. aldosterone, blood pressure) and metabolic markers did not show a consistent association with sleep changes. The degree of improvement in PSQI was significantly associated with the improvement of brief patients health questionnaire (PHQD) (p = 0.0151). Sleep disturbances seem not to be an independent risk factor for cardiovascular and metabolic problems in PA. They are strongly associated to depressive symptoms and maybe mediated by the same mineralocorticoid receptor circuits.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:172

Enthalten in:

Journal of psychiatric research - 172(2024) vom: 28. Apr., Seite 66-70

Sprache:

Englisch

Beteiligte Personen:

Adolf, Christian [VerfasserIn]
Murck, Harald [VerfasserIn]
Sarkis, Anna-Lina [VerfasserIn]
Schneider, Holger [VerfasserIn]
Fischer, Ina [VerfasserIn]
Steiger, Axel [VerfasserIn]
Braun, Leah T [VerfasserIn]
Reincke, Martin [VerfasserIn]
Künzel, Heike [VerfasserIn]

Links:

Volltext

Themen:

4964P6T9RB
Aldosterone
Anxiety
Depression
Journal Article
Primary aldosteronism
Sleep

Anmerkungen:

Date Completed 01.04.2024

Date Revised 01.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jpsychires.2024.01.042

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368573826