Article

Obstructive sleep apnea in hypothyroidism

Annals of internal medicine (Impact Factor: 16.1). 11/1984; 101(4):491-4.
Source: PubMed

ABSTRACT To determine the incidence and frequency of sleep apnea in persons with hypothyroidism, 11 consecutive patients with newly diagnosed disease were studied before and during thyroid hormone replacement therapy. Nine patients had episodes of apnea, with the number of episodes per hour of sleep ranging from 17 to 176 (mean, 71.8). Six of the nine patients were obese and had 99.5 episodes per hour compared with 16.3 episodes per hour in the 3 nonobese patients (p less than 0.02). After 3 to 12 months of thyroxine replacement therapy, mean apnea frequency decreased from 71.8 +/- 18.0 (SE) to 12.7 +/- 6.1 episodes per hour, without reduction in body weight. There were fewer changes in sleep stage per hour during treatment (22.1 +/- 4.9) than pretreatment (57.6 +/- 14.5). Carbon dioxide response tests done under non-loaded and flow-resistive loaded conditions before and during thyroxine replacement therapy showed increases in the loaded respiratory effort and ventilation during thyroxine treatment. Sleep apnea episodes are common in persons with untreated hypothyroidism, even with normal lung function. Thyroxine replacement therapy decreases apnea frequency, even without change in body weight.

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    • "Obstructive sleep apnea syndrome is common in severe hypothyroidism but it is reversible with restoration of a euthyroid state (Larsen PR & Davies TF, 2003). The prominent features like somnolence, apathy and lethargy may also recover with replacement therapy (Krishnan R et al., 1984, Jameson JL & Weetman AP, 2001). Muscle strength measurement and sleep investigation is not routine analysis in these patients, so simple spirometric evaluation is preferred. "
    Hypothyroidism - Influences and Treatments, 02/2012; , ISBN: 978-953-51-0021-8
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    ABSTRACT: Süleyman Demirel Üniversitesi TIP FAKÜLTESİ DERGİSİ: 2008 Aralık; 15 (4) Obstrüktif uyku apne sendromu olgularında hipotiroidi taraması yapılmalı mı? Nurçin Çimen Özışık*, Gülfem Yurteri**, Bahar Tüzün***, Önder Öztürk****, Özlem Oruç* Özet Amaç: Hipotiroidi ve Obstrüktif Uyku Apne Sendromu (OSAS) birlikteliği %1.2-11 arasında değişen oranlarda bildirilmektedir. Iki hastalığın bir arada bulunduğu olgulara, uyku laboratuarlarına başvurduklarında yapılan polisomnografi (PSG) ile OSAS tanısı konulmakta ancak mevcut hipotiroidi gözden kaçabilmektedir. Bu çalışmada Süreyyapaşa Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim Araştırma Hastanesi Uyku Bozuklukları Merkezi.ne başvurarak OSAS tanısı konulan hastalarda hipotiroidi görülme sıklığını araştırmayı ve hipotiroidi saptanan hastaların hormon replasman tedavisi sonrası durumlarını değerlendirmeyi amaçladık. Gereç ve Yöntemler: Ekim 2005-0cak 2006 tarihleri arasında OSAS şüphesi ile merkezimize başvurarak tüm gece PSG.leri yapılan 46 olgudan tiroid fonksiyon testleri istendi. Bulgular: Hastaların 37.sinde (%80.4) apne hipopne indeksi (AHI) 5 ve üzerinde bulunarak OSAS tanısı kondu. Hastaların 20.sinin (%54) ağır, 5.inin (%13.6) orta ve 12.unun (%32.4) hafif OSAS olduğu görüldü. 37 OSAS.lı vakanın 2.sinin (%5.4) hipotiroidi olduğu saptandı. Her iki vaka da ağır OSAS.lı idi. Hipotiroidi saptanan bu olgulara tiroid hormon replasman tedavisi verildi. Uygun replasman tedavisi sonrasında PSG tekrarlandı. Semptomlarda gerileme ve AHI değerlerinde azalma gözlendi. Sonuç: Çalışmamızda bulunan OSAS ve hipotiroidi birlikteliği literatür ile uyumlu idi. Uyku laboratuarlarına OSAS şüphesi ile başvuran tüm hastalarda hipotiroidi taraması yapılmasının gerekli olduğu sonucuna varıldı. Anahtar kelimeler: Obstrüktif Uyku Apne Sendromu (OSAS), hipotiroidi, tanı, tedavi Abstract Should Patients With Obstructive Sleep Apnea Syndrome Be Screened For Hypothyroidisim? Aim: The association of hypothyroidism with the obstructive sleep apnea syndrome (OSAS) has been reported at varying rates of 1.2 % to 11 %. In patients with OSAS the diagnosis of hypothyroidism can easily be missed. In our study, we aimed to determine the prevalence of hypothyroidism in patients who were diagnosed as OSAS in our sleep center and the effects of hypothyroidism treatment on OSAS. Material and Method: Forty-six patients were undertaken the polysomnographic study with the suspicion of OSAS between October 2005- January 2006. Thyroid function tests were studied in these patients. Results: Thirty seven (80.4%) cases were diagnosed as OSAS. Twenty (54%) cases were classified as severe OSAS, 5 (13.6%) cases were classified as moderate OSAS and 12 (32.4%) cases were classified as mild OSAS. Hypothyroidism was detected in 2 of those 37 OSAS patients (5.4%). Both of them were severe OSAS. Thyroid hormone replacement treatment(THRT) was given to these cases. After THRT polysomnography was repeated. Obstructive symptoms and AHI scores reduced significantly. Conclusion: In our study the prevalence of hypothyroidism and OSAS was found compatible with the literature, and we conclude that biochemical screening for hypothyroidism is necessary for all patients with suspicion of OSAS. Key words: Obstructive Sleep Apnea Syndrome (OSAS), hypothyroidism, diagnosis, treatment
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