Sleep apnoea syndrome (SAS) is common in acromegalic patients. Occasionally, the relief of apnoeas after treatment of the acromegaly has been documented. We report the cases of three patients with acromegaly and severe obstructive sleep apnoea, who demonstrated a manifest improvement (respiratory disturbance index (RDI) <20) after treatment with octreotide, indicating that this drug may be effective in this disturbance.In one case, SAS disappeared although the growth hormone level was not fully normalized. This raises the intriguing hypothesis that octreotide has an effect on respiratory control or on the upper airway, that is not directly related to its action on production of growth hormone. Eur Respir J 1997; 10: 1401-1404 Sleep apnoea syndrome (SAS) is common in acromegalic patients. The aetiology is upper airway obstruction in two thirds of cases, and is of central nervous origin in one third [1,2]. Other factors, including hormonal influence on the respiratory control centre, may be involved. Improvement of SAS following treatment for acromegaly (with octreotide, bromocriptine, adenomectomy and/or radiotherapy) has been documented in several publications [3][4][5][6][7][8][9][10][11].We report the cases of three acromegalic patients with SAS which improved after treatment of their acromegaly. We emphasize the clear-cut favourable influence of octreotide on the degree of SAS. We also review the literature concerning objective polygraphic amelioration of the SAS after treating the acromegaly. Materials and methods Sleep studiesPatients underwent overnight sleep studies in our sleep laboratory. Polysomnography consisted of electroencephalogram, electro-oculogram, electrocardiogram, electromyogram, chest wall and abdominal plethysmogram, oronasal airflow monitoring, and continuous registration of transcutaneous oxygen. To assess the severity of sleep apnoea, the following indices were measured: number of apnoeas (absence of airflow during ≥10 s); number of hypopnoeas (reduction of airflow by 50% during ≥10 s with at least 4% desaturation); respiratory disturbance index (RDI), i.e. number of apnoeas and hypopnoeas per hour of sleep; mean transcutaneous oxygen saturation; minimum transcutaneous oxygen saturation; and duration of desaturation (% of total sleep time with transcutaneous oxygen saturation (Stc,O 2 ) <90%). Sleep efficiency, percentage rapid eye movement (REM) and slow wave sleep were also assessed. Measurements of the endocrine statusSerum growth hormone (GH) and somatomedin C levels were determined using a radioimmunoassay (RIA) method (normal serum GH <7.5 ng·mL -1 ; normal somatomedin C <300 ng·mL -1 ). Case reports (table 1)Case No. 1 A 68 yr old man presented with daytime hypersomnolence. He manifested acral growth. The fasting serum GH and somatomedin C levels were markedly raised. A radiographic image of the skull demonstrated a pituitary tumour. At polysomnography, a severe obstructive SAS was diagnosed. The apnoeas and hypopnoeas were treated with nasal continuous positive airway ...

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