Endocrine Abstracts

JOINT1051

Background: Pituitary dysfunction can significantly impact sleep quality, mental health, and fatigue, leading to a reduced quality of life. Despite these well-recognized issues, systematic assessments across different subtypes of pituitary dysfunction remain limited. Therefore, this survey was developed to address this gap by evaluating these symptoms in a large, diverse cohort of patients with pituitary conditions.

Methods: This cross-sectional, web-based, anonymous survey study was designed to capture patient-reported outcomes on sleep quality, mental health, and fatigue. Participants included adults with isolated anterior pituitary dysfunction (APD), isolated posterior pituitary dysfunction (arginine vasopressin deficiency, AVP-D), combined anterior and posterior pituitary dysfunction (PanHypo), and those with pituitary conditions but no hormone deficiency or excess (e.g., non-functioning pituitary adenomas) as clinical controls. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), mental health using the Patient Health Questionnaire-9 (PHQ-9) and the State-Trait Anxiety Inventory (STAI-T), fatigue levels using the Fatigue Severity Scale (FSS), insomnia levels using the Insomnia Severity Index (ISI), and daytime sleepiness using the Epworth Sleepiness Scale (ESS). Higher scores on the PSQI, FSS, ISI, ESS, PHQ-9 and STAI-T indicated worse outcomes. Total scores were compared across groups and adjusted for sex, age, and the Charlson Comorbidity Index.

Findings: Between September 2024 and November 2024, 451 patients participated in the survey. The median age was 52 years [42–60], with 80% female participants and a median duration of pituitary dysfunction of 7 years. Participants were classified as APD (42.6 %), AVP-D (19.3 %), PanHypo (26.6 %), and clinical controls (11.5 %). The most common etiologies for a pituitary dysfunction were pituitary tumors or cysts (61.6 %) and idiopathic (18.4 %). Patients across all groups showed impaired sleep quality, clinical levels of anxiety, and sub-clinical levels of depression. Fatigue and insomnia levels were uniformly high, with significant variability in insomnia levels across subgroups.

Conclusion: This large, systematic survey demonstrates that sleep disturbances, anxiety, and fatigue are prevalent across all subtypes of pituitary dysfunction. The findings highlight the need for targeted diagnostics and interventions to address these symptoms, which significantly affect the quality of life in patients with pituitary conditions.