Three-week actigraphy to assess sleep behaviour and circadian rest-activity patterns in suspected and confirmed Cushing’s syndrome: an exploratory prospective cohort study
Authors' conclusion
Apart from chronotype, actigraphy showed limited discriminatory value between clinical groups. LNSC was highly variable and showed no consistent associations with sleep parameters, underscoring the need for improved biomarkers and monitoring strategies in CS.
Study context
- Population
- Individuals evaluated for suspected Cushing's syndrome (CS) and patients with CS in remission, LMU Hospital Munich; 21-day actigraphy, daily late-night salivary cortisol (LNSC), Munich Chronotype Questionnairetwo cohorts
- Participants
- 16 / 13 / 13 / 10
- Exposure
- Confirmed CS vs exclusion of CS (cohort 1); persistent vs recovered adrenal insufficiency in remission (cohort 2)
- Confirmed CSn = 16
- Exclusion of CSn = 13reference
- Persistent adrenal insufficiencyn = 13
- Recovered adrenal insufficiencyn = 10reference
- Outcome
- Actigraphy sleep and circadian rest-activity measures in suspected CS
- Follow-up
- 21 days
Methodological detailsexploratory, single-centre
- Exploratory
- Single-centre
Main finding
As reported in the abstract
21 days
- Comparable sleep efficiency, fragmentation and circadian rest-activity rhythms in both groups, without distinct alterations attributable to active CS
- Confirmed CS vs Exclusion of CS: P = 0.022
- Exploratory
Observational data: associations, not effects.
Further findings
Sleep characteristics in remission (cohort 2)
- Similar sleep characteristics across persistent and recovered adrenal insufficiency subgroups
LNSC and actigraphy sleep parameters
- LNSC showed high inter- and intraindividual variability without consistent associations with actigraphy sleep parameters
- Persistent adrenal insufficiency only: higher LNSC associated with earlier bedtime, longer time in bed, prolonged sleep-onset latency and reduced sleep efficiency
Original publication
Three-week actigraphy to assess sleep behaviour and circadian rest-activity patterns in suspected and confirmed Cushing’s syndrome: an exploratory prospective cohort study. Pituitary. Published 16 June 2026. doi:10.
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