Hyperthyroidism in Graves’ disease causes sleep disorders related to sympathetic hypertonia

2022 ◽  
Author(s):  
Kazuhisa Matsumoto ◽  
Shoichiro Izawa ◽  
Kenji Fukaya ◽  
Eriko Matsuda ◽  
Misato Fujiyama ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Thyroid Function ◽  
Associated Factors ◽  
Clinical Course ◽  
Graves Disease ◽  
Newly Diagnosed ◽  
Normal Thyroid Function ◽  
Study Participants

Abstract Context It is well known that Graves’ disease (GD) causes sleep disorders (SD). However, the characteristics and associated factors of SD and its clinical course post-hyperthyroidism normalization remain unclear. Objective To clarify the characteristics and associated factors of subjective SD and its clinical course after GD treatment. Design, setting, and study participants From November 2017 to October 2020, we enrolled 72 participants (22 newly diagnosed with GD with untreated hyperthyroidism, 20 previously diagnosed with GD with normal thyroid function, and 30 normal controls) with no other underlying sleep disorder-related diseases. We compared the groups at enrollment and conducted prospective observations after 12 months of treatment on participants with newly diagnosed GD. Main outcome measures Differences and changes in the Pittsburgh Sleep Quality Index (PSQI) global and component sleep quality scores. Results PSQI global sleep quality scores (p = 0.036) and sleep disturbance scores (p = 0.011) were significantly different among the three groups, and were highest in the untreated hyperthyroidism group. Multiple regression analysis demonstrated that free thyroxine level, which was positively correlated with sympathetic tone (ST) as evaluated by pulse rate and urinary total metanephrines, was associated with poorer PSQI global sleep quality scores independently of other factors (p = 0.006). Prospective observation showed that PSQI global sleep quality scores (p = 0.018) and sleep disturbance scores (p = 0.011) significantly improved with thyroid function normalization and ST attenuation. Conclusions Hyperthyroidism caused by GD augmented ST and exacerbated subjective SD. Normalization of hyperthyroidism caused by GD improved subjective SD.

scholarly journals Clinical course of euthyroid subjects with positive TSH receptor antibody: how often does Graves’ disease develop?

2021 ◽  
Author(s):  
Nami Suzuki ◽  
Akiko Kawaguchi ◽  
Jaeduk Yoshimura Noh ◽  
Ran Yoshimura ◽  
Kentaro Mikura ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Clinical Course ◽  
Tsh Receptor ◽  
Graves Disease ◽  
Normal Thyroid ◽  
Receptor Antibody ◽  
Female Patients ◽  
Tsh Receptor Antibody ◽  
Normal Thyroid Function ◽  
Positive Results

Abstract Background Thyroid stimulating hormone (TSH) receptor antibody (TRAb) is detected in the serum of patients with Graves’ disease (GD). This study aims to investigate the prevalence of euthyroid individuals showing positive results for TRAb and to clarify the clinical course of thyroid function and TRAb levels in these subjects. Objective Subjects were female patients who newly visited our hospital for a screening test prior to fertility treatment and showed normal thyroid function and volume without nodules between 2014 and 2017. After excluding subjects with a history of thyroid disease, 5,622 subjects were analyzed. Results Forty-seven of the 5,622 subjects showed positive results for TRAb (reference range, < 2.0 IU/L) at the initial visit. Median initial TRAb was 2.9 IU/L (range, 2.0 -14.7 IU/L) and median follow-up was 18.3 months (range, 0- 66.5 months). Six of the 47 subjects (12.8%) developed GD and median duration until development was 6.6 months (range, 1.2 -13.2 months). Median TRAb values initially and at diagnosisof GD for those 6 patients were 3.7 IU/L (range, 2.7 -5.1 IU/L) and 7.2 IU/L (range 3.6 -21.4 IU/L), respectively. TRAb results turned negative for 20 of the 47 subjects, but remained positive despite normal thyroid function in 13 of the 47 subjects. Conclusion GD developed over time in 12.8% of euthyroid young female patients showing positive TRAb within a median of 6.6 months. A positive result for TRAb itself did not mean development of GD, so other factors must be essential for the pathogenesis of GD.

scholarly journals Prevalence of Sleep Disturbance and Potential Associated Factors among Medical Students from Mashhad, Iran

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ahmad Janatmakan Amiri ◽  
Negar Morovatdar ◽  
Atefeh Soltanifar ◽  
Ramin Rezaee
Keyword(s):  
Medical Students ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Associated Factors ◽  
Sleep Problems ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Related Factors ◽  
Cross Sectional

Study Objectives. A very limited number of studies have evaluated the prevalence of sleep problems, and related factors, in Iranian medical students. The aim of this study was to determine the prevalence of sleep disturbance and potential associated factors among medical students of Mashhad University of Medical Sciences, Mashhad, Iran. Methods. In this cross-sectional study, 315 medical students chosen by stratified random sampling participated in the academic year 2018-2019. The Pittsburgh Instrument and DASS-21 questionnaire were used to evaluate sleep quality and anxiety, depression, and stress, respectively. Also, demographic, educational, and socioeconomic information was collected. SPSS 16 software was used for data analysis. Results. Out of 300 students who completed the questionnaires, 165 (55%) were male, with a mean age of 21.94±2.28 years old. The prevalence of poor sleep quality was 51.3%. We did not find significant associations among age, sex, and poor sleep quality. Concurrent psychological symptoms such as stress, depression, and anxiety were significantly associated with sleep disorders. After adjusting variables in the multivariable regression model, depression (OR=2.81, 95% CI: 1.35-5.87; p=0.006) and the number of hours spent on using smartphones in 24 hours (OR=1.13, 95% CI: 1.02-1.25; p=0.01) were significantly associated with poor sleep quality among medical students. Conclusion. The prevalence of poor sleep quality among medical students was high, and we found that increased use of smartphones during the day and depression were associated with sleep disorders.

scholarly journals Evaluation of Subjective Sleep Disturbances in Cancer Patients: A Cross-Sectional Study in a Radiotherapy Department

2021 ◽  
Vol 12 ◽  
Author(s):  
Jun Wang ◽  
Bei-Yun Zhou ◽  
Chen-Lu Lian ◽  
Ping Zhou ◽  
Hui-Juan Lin ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Cancer Patients ◽  
Sleep Disturbances ◽  
Cancer Type ◽  
Multivariate Logistic Regression ◽  
Subjective Sleep ◽  
Radiotherapy Department

Background: The factors associated with sleep disturbances in cancer patients remains unclear. This study aimed to explore the prevalence of sleep disorders and predictors associated with sleep disturbance in cancer patients from a radiotherapy department.Methods: Patients with cancers were recruited before the start of radiotherapy from our institution between January 2019 and February 2020. Pittsburgh Sleep Quality Index (PSQI) scale was used to assess sleep quality. Descriptive statistics, Chi-square test, and multivariate logistic regression analysis were used to conduct statistical analysis.Results: A total of 330 eligible patients were included. Of them, 38.3% (n = 127) had the globe PSQI score >7, indicating that they suffered from sleep disorders. Patients with lung cancer (45.2%) were more likely to suffer from sleep disturbance, followed by cervical cancer (43.8%), nasopharyngeal carcinoma (41.7%), esophageal cancer (41.5%), breast cancer (37.7%), and colorectal cancer (30%). With regard to the PSQI components, the mean sleep duration was 8 h, 20.3% (n = 67) of them reported poor subjective sleep quality, 6.1% (n = 20) needed medication to improve sleep, and 53.6% (n = 177) suffered daytime dysfunction. Multivariate logistic regression models showed body mass index (BMI) ≥ 20 kg/m2 [odds ratio (OR) 0.599, 95% confidence interval (CI) 0.329–0.948, P = 0.031] and the receipt of surgery (OR 0.507, 95% CI 0.258–0.996, P = 0.048) were the significant favorable predictors for sleep disturbance, while age, gender, marital status, education level, comorbidity, metastasis status, diagnostic status, and cancer type were not significantly associated with sleep disturbance.Conclusions: Approximately 40% of the cancer patients suffer from sleep disturbance before the start of radiotherapy. Patients with BMI ≥ 20 kg/m2 and receiving surgery are less likely to develop sleep disturbance in comparison with others.

scholarly journals Prevalence, Correlations, and Impact of Sleep Disturbance in Chinese Meningioma Patients

2021 ◽  
Author(s):  
Dandan Zhang ◽  
Jing Wang ◽  
Xixi Gu ◽  
Zhifeng Gu ◽  
Liren Li ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Short Form ◽  
Binary Logistic Regression ◽  
Anxiety And Depression ◽  
Newly Diagnosed ◽  
Chi Square Analysis

Abstract Purpose Sleep disturbance is common in meningioma patients and may lead to disease aggravation and decreases health-related quality of life (HRQoL). However, the sleep quality of meningioma patients newly diagnosed and ready for surgery has not been well clarified in China. This study aims to evaluate the prevalence, correlates, and impact of sleep disturbance among Chinese meningioma patients. Methods In this cross-sectional study, meningioma patients were recruited from the Affiliated Hospital of Nantong University from January 2020 to November 2020. A series of questionnaires were applied: the 0–10 Numerical Rating Scale (NRS), the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Fatigue Inventory (MFI-20), the Epworth Sleepiness Scale (ESS), the Short-Form 36 (SF-36), the Pittsburgh Sleep Quality Index (PSQI). Independent samples t test, Mann-Whitney U test, chi-square analysis, Pearson/Spearman correlation, and binary logistic regression were used to analyze the data. Results 100 meningioma patients completed the questionnaires. Sleep disturbance affected 43% of the meningioma patients and was linked to many concomitant symptoms, such as headache, fatigue, anxiety and depression. Binary logistic regression indicated that fatigue and headache were predictors of sleep disturbance in meningioma patients. Meanwhile, severe sleep disturbance led to lower quality of life. Conclusions These findings demonstrated that a considerable number of meningioma patients newly diagnosed and ready for surgery suffered from sleep disturbance, potentially contributing to impair HRQoL. Medical personnel should pay more attention to meningioma patients with sleep disturbance and take effective measures to improve sleep quality, with the ultimate goal to improve their HRQoL.

Sleep quality in heroin addicts under methadone maintenance treatment

2012 ◽  
Vol 24 (6) ◽  
pp. 356-360 ◽  
Author(s):  
Wen-Yu Hsu ◽  
Nan-Ying Chiu ◽  
Jui-Ting Liu ◽  
Chieh-Hui Wang ◽  
Ting-Gang Chang ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Opiate Withdrawal ◽  
Heroin Addicts ◽  
Methadone Dosage ◽  
Opiate Addicts

Hsu W-Y, Chiu N-Y, Liu J-T, Wang C-H, Chang T-G, Liao Y-C, Kuo P-I. Sleep quality in heroin addicts under methadone maintenance treatment.Background: Sleep disturbance is a common phenomenon among opiate addicts. The side effects of opiate addiction or opiate withdrawal might result in sleep disturbance. However, their problems might be related to sedative medication abuse, alcohol abuse or heroin relapse. Sleep is an important issue in this population.Objective: To evaluate the prevalence of sleep disorders in heroin addicts receiving methadone maintenance treatment (MMT) and analyse the correlation between related factors, such as age at opiate exposure, opiate exposure duration, duration in MMT, methadone current dosage, methadone attendance rate and the severity of sleep disorders.Method: We enrolled 121 heroin addicts who were receiving MMT. We collected data on the duration of insomnia, hypnotic history, Visual Analogue Scale-10 of sleep quality, Pittsburgh Sleep Quality Index (PSQI), methadone dosage, methadone history and opiate history.Results: The mean of the PSQI was 9.1 ± 5.4, and 70.2% of patients had PSQI scores >5, indicating they were poor sleepers. We also found the PSQI scores were correlated significantly with the methadone dosage.Conclusions: The sleep disturbance prevalence rate of opiate addicts under MMT was high in Taiwan, as shown in the previous studies, and the severity of sleep disturbance has been underestimated.

scholarly journals Quality of sleep and associated factors among people living with HIV/AIDS on follow up at Ethiopian Zewditu Memorial Hospital,2018

2020 ◽  
Author(s):  
Nebiyu Mengistu ◽  
Telake Azale ◽  
Solomon Yimer ◽  
Mahilet Fikreyesus ◽  
Elsa Melaku ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Associated Factors ◽  
Poor Sleep ◽  
People Living With Hiv ◽  
Quality Of Sleep ◽  
Poor Sleep Quality ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background: Sleep disturbance is a common complaint in people living with HIV/AIDS. Despite the influence of sleep disturbance on treatment adherence, quality of life, work productivity, risk of chronic illness, it remains under-recognized and under-studied in Ethiopia. Therefore it is necessary to produce scientific evidence to fill the knowledge gap and areas of management. The current study aimed to assess sleep quality and its associated factors among people living with HIV/AIDS. Methods: An institution-based cross-sectional study was utilized among 408 participants who were selected by a systematic random sampling technique at Zewditu memorial hospital from April to May 2018. The Pittsburgh Sleep Quality Index questionnaire was used to measure sleep quality. Ethical clearance was obtained from the joint ethics committee of the University of Gondar and Amanuel Mental Specialized Hospital. Oral informed consent was obtained from each participant. Binary and multivariable logistic regression models were fitted. Odds ratios (OR) with the corresponding 95% confidence interval (95%CI) was computed. Results: The magnitude of poor sleep quality was 55.6%. Being female [AOR=3.40, 95% CI: (1.80, 6.41)], depression [AOR =3.52, 95% CI: (1.95, 6.32)], CD4count ≤ 200 cells/mm3 [AOR=3.18,95%CI: (1.65,6.13)], duration of HIV/AIDS diagnosis [AOR=3.43,95% CI: (1.61,7.29)], current use of tobacco [AOR=5.69, 95% CI: (2.04,15.9)] and chat or caffeinated drinks [AOR=2.65, 95% CI: (1.06,6.64)] and poor sleep hygiene [AOR=3.55, 95% CI: (1.85, 6.78)] were significantly associated with poor sleep quality.Conclusions: More than half of the study participants were found to have poor sleep quality. A range factors influence quality of sleep of people with HIV/AIDS. Routine screening of sleep condition among people living with HIV/AIDS and early intervention based on the findings is suggested.

scholarly journals Sleep quality and associated factors among patients with chronic illness at South Wollo Zone Public Hospitals, Northeast Ethiopia

2021 ◽  
Vol 5 (1) ◽  
pp. 043-050
Author(s):  
Edmealem Afework ◽  
Ademe Sewunet ◽  
Andualem Atsedemariam
Keyword(s):  
Chronic Illness ◽  
Sleep Quality ◽  
Associated Factors ◽  
Public Hospitals ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Northeast Ethiopia ◽  
Ethical Approval ◽  
Study Participants

Background: Pathological and nighttime sleep deprivations have substantial adverse effects on regulation of weight, sugar and blood pressure because of endothelial dysfunction, sympathetic nervous system stimulation, regulation and activation of systemic inflammation. Thus, this study was aimed to assess quality of sleep among patients with chronic illness and its associated factors at South Wollo Zone Public Hospitals, Northeast Ethiopia. Methods and Materials: The study was conducted at South Wollo Zone Public Hospitals, Northeast Ethiopia from February 15 2019 till April 15 2019. Institutional based cross sectional study design was employed. All patients with chronic illness who are on follow up in South Wollo Zone Public Hospitals were sources of population. Sample size was calculated by using EPI info version 7 and the total sample size was 344. The study employed stratified random sampling technique and study participants were selected by systematic sampling. After taking ethical approval from College of Medicine and Health Sciences Ethical Approval Committee, permission from selected Hospitals and informed verbal consent from patients, the data were collected by a tool which has 3 parts: Sociodemographic data, Pittsburgh Sleep Quality Index and factors affecting sleep quality. Data were entered in to Epi data version 4.1 and exported to Statistical Package for Service Product 25 for analysis. Different data presentation tools and binary logistic regression were enrolled by considering 95% confidence level and p value of 0.05. Result: Among the total study participants, near to one third (31.7%) of them got sleep after 30 minutes. More than one fourth of them slept for less than 7 hours. Less than half of the study participants had habitual sleep efficiency of more than 85% however 296(86%) of them did not face day time dysfunction Conclusion and recommendations: more than one third of patients with chronic illness had poor sleep quality. One third of study participants had sleep duration of less than the recommendations(less than 7 hours). Age, educational status, residence, and perception of prognosis of disease were factors that have associations with poor sleep quality among patients with chronic illness. Health care providers who are doing in chronic illness follow up clinic should be initiated to assess and screen those patients with poor sleep quality.

scholarly journals Parameters affecting the period for being euthyroid in newly-diagnosed Graves’ disease treated with antithyroid agent

2020 ◽  
Vol 8 (9) ◽  
pp. 3165
Author(s):  
Iskender Ekinci ◽  
Hande Peynirci
Keyword(s):  
Thyroid Function ◽  
Smoking Status ◽  
Antithyroid Drug ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Newly Diagnosed ◽  
Function Tests ◽  
Significant Difference ◽  
Stimulating Hormone

Background: There are limited data about the factors affecting the response time to medical treatment in Graves’ disease (GD) although many studies examined the predictors of the relapse after drug withdrawal. The aim of the current study was to evaluate the time for becoming euthyroid under antithyroid drug (ATD) therapy and the parameters influencing this period in patients diagnosed as GD.Methods: Patients with newly-diagnosed GD and decided to treat with ATD initially between March 2017 and September 2018 were retrieved retrospectively. Sociodemographic features as well as laboratory parameters like thyroid function tests and thyroid-stimulating hormone-receptor antibody (TRab) at the time of diagnosis were recorded.Results: Out of 41 patients, 63.4% (n=26) were female. The mean age was 36.1±11.7 years and 43.9% (n=18) of them were smoking. The time between the initiation of treatment and the duration of becoming euthyroid was 2.4±1.8 months. No significant difference was noted between age, gender, and smoking status and the time to become euthyroid under ATD treatment. This period was significantly positively correlated with levels of free triiodothyronine, free thyroxine, and negatively correlated with thyroid-stimulating hormone. Response to ATD therapy was higher in patients with pre-treatment TRab levels <10 IU/l than TRab ≥10 IU/l (p=0.011).Conclusions: Pretreatment thyroid function tests and TRab levels may be taken into consideration before deciding treatment in patients with newly diagnosed GD. It would be useful to design more comprehensive studies so that this proposal can find a response in clinical practice.

scholarly journals Sleep Disturbance and Associated Factors among Adult People Living with HIV/AIDS at Dessie Referral Hospital Antiretroviral therapy clinic, Northeast, Ethiopia

2020 ◽  
Author(s):  
Fatuma Degu ◽  
Yeneabat Birhanu ◽  
Abere Azagew
Keyword(s):  
Sleep Disturbance ◽  
Associated Factors ◽  
Antiretroviral Drugs ◽  
Stage Ii ◽  
Living Alone ◽  
People Living With Hiv ◽  
Study Participants ◽  
Living With Hiv ◽  
Cd4 Cell ◽  
Hiv Aids

Abstract Background Sleep disturbance is the leading health problem in the era of HIV/AIDS. The exact cause of sleep disturbance was not well known, but it is related to HIV itself, antiretroviral drugs side effect, and other HIV related disorders. This study aimed to assess the prevalence of sleep disturbance and associated factors among adult people living with HIV/AIDS. Methods A cross-sectional study was conducted. A total of 419 study participants participated in the study. A systematic random sampling method was employed. An interviewer-administered a method of data collection with a chart review was used. Pittsburg Sleep Quality of Index for assessing sleep disturbance was used. A binary logistic regression was conducted. The variables having a p-value < 0.05 with 95% CI were used to declare an association. Results The prevalence of sleep disturbance was 36% (95% CI: 31–41%). The study revealed that being female (AOR = 3.45, 95% CI: 1.52–7.79), viral loads ≥ 1000 copies /ml (AOR = 6.88, 95% CI: 2.79–16.9), CD4 cell count < 200 cells/mm3 (AOR = 6.85, 95% CI: 2.42–19.39), WHO stage II and III(AOR = 4.29, 95%CI: 1.05–17.53), having anxiety (AOR = 10,95% CI: 4.21–23.9), having depression (AOR = 4.4, 95% CI: 1.95–10.1), having not a separated bedroom (AOR = 3.94, 95% CI: 1.86–8.36), and living alone (AOR = 6, 95% CI: 2.81–13.12) were found to be factors associated with sleep disturbance. Conclusion In this study, more than one - thirds of the study participants were developed sleep disturbance. Being female, low CD4 cell counts, viral load ≥ 1000copies/ml, WHO stage II and III, having depression and anxiety, living alone, and have not a separate bedroom have increased the experience of sleep disturbance.

scholarly journals Nephrotic Syndrome as a Cause of Transient Clinical Hypothyroidism

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Vânia Benido Silva ◽  
Maria Teresa Pereira ◽  
Carla Leal Moreira ◽  
Sílvia Santos Monteiro ◽  
Isabel Inácio ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Thyroid Function ◽  
Early Stage ◽  
Case Reports ◽  
Overt Hypothyroidism ◽  
Newly Diagnosed ◽  
Bilateral Nephrectomy ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
High Prevalence

Nephrotic syndrome may trigger the onset of hypothyroidism, promoting massive urinary protein losses including thyroxine (T4) and triiodothyronine (T3) along with their binding proteins. At an early stage, a clinical and biochemical euthyroid state is expected. However, in patients with prolonged and severe proteinuria, especially with concomitant low thyroid reserve, urinary losses of free and protein-bound thyroid hormones are sufficiently pronounced to induce a subclinical or overt hypothyroidism. Despite its high prevalence in clinical practice, the literature lacks case reports of newly diagnosed clinical hypothyroidism due to NS in adults, making this condition under-recognized. We report a case of a 23-year-old man with previous normal thyroid function who developed overt hypothyroidism due to a severe nephrotic syndrome, requiring supplementation with levothyroxine (LT). After the patient had undergone bilateral nephrectomy, treatment with LT was discontinued and thyroid function normalized.

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