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hydrocortisone in the morning vs a higher dose at night in children, showed no difference in overall 24-h control of markers of adrenal androgen excess ( 2 ). Anecdotally, some patients complain of poor sleep when taking glucocorticoids at night and taking
IRCCS, Istituto Auxologico Italiano, Milan, Italy
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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= 97). Initial symptoms A broad range of signs and symptoms were initially noticed by patients, with weight gain, hirsutism or acne, fatigue, sleep disturbances, depressive symptoms, muscle weakness, anxiety and hypertension all being reported
Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), ISCIII, Spain
Department of Endocrinology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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, appearance of more body hair, snoring or sleep apnea, weight gain, skin thickening, jaw growth with toothache, high blood pressure Feeling ‘something is wrong’ Psychological: insomnia, lack of concentration, less memory, unreasonable nervousness, depression
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-called ‘pseudo-Cushing’s’ and those with subclinical CS in our study. Crucially, an experienced clinician’s assessment is the most important factor to correctly diagnose CS. For example, conditions like obstructive sleep apnoea result in hypoxia-induced stress
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NIHR Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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.999 Sleep apnoea, n (%) 3 (3.7) – 0.246 Depression, n (%) 3 (3.7) 6 (7.5) 0.325 History of cancer, n (%) 2 (2.4) 1 (1.3) >0.999 Candidiasis, n (%) 1 (1.2) – >0.999 Testicular adrenal rest
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Medicine Department, Basque Country University, Bilbao, Spain
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University of Alcalá, Madrid, Spain
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diabetes mellitus, obesity, dyslipidemia and sleep apnea syndrome. Information about pharmacological history with antihypertensive (type, number, and doses), oral antidiabetic and lipid-lowering medications, potassium supplements and antiplatelet agents was
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) 0.42 Chronic kidney disease 11.8% ( n = 6) 9.6% ( n = 12/125) 0.67 Sleep apnea syndrome ( n = 170) 6.3% ( n = 3/48) 16.4% ( n = 20/122) 0.08 Active smoking ( n = 173) 26.5% ( n = 13/49) 14.5% ( n = 18
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; problems with the oral mucosa or saliva; current pregnancy; abnormal circadian rhythm (not sleeping at night between 00:30 and 05:00 h). The study was approved by the local ethics committee in Umeå (Dnr 2018-162-31M). Written informed consent was obtained
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Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
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). Although adverse effects in mothers have not been extensively investigated, the studies that did assess these found that on the short term, common reversible side effects in treated mothers included oedema, severe striae, sleep disturbances and weight gain