Do sleep disorders cause endocrine disease or does endocrine disease cause sleep disorders?
Both are true. Sleep experts have dubbed sleep symptoms as the “canary in the mine” for serious medical and psychological diseases. Sleep quality evaluation can be a tool for assessment of disease. Additionally, sleep disorders are common in many endocrine diseases. For example, patients with acromegaly are at risk for sleep apnea (see question 27). Excessive androgens can worsen OSA, as can hypothyroidism. Thyrotoxicosis can contribute to debilitating insomnia, with profound daytime fatigue accompanying other presenting complaints. Disruptive sleep is now known to be associated with increased risk for diabetes and shortened sleep is associated with obesity. Assessment of the sleep habits of patients is often omitted in the pursuit of human pathophysiology. But sleep quality and quantity (i.e., sleep architecture) can be vital to anticipating components of disease.