Acromegaly in sleep apnoea patients: a large observational study of 755 patients

Galerneau, Louis-Marie; Pépin, Jean‐Louis; Borel, Anne‐Laure; Chabre, Olivier; Sapène, Marc; Stach, B.; Girey-Rannaud, Janie; Arnol, Nathalie; Tamisier, Renaud; Caron, Philippe

doi:10.1183/13993003.01229-2016

Cited by 21 publications

(30 citation statements)

References 14 publications

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“…We analysed data from the French national sleep apnoea registry 'Observatoire Sommeil de la Fédération de Pneumologie' (OSFP) (www.osfp.fr). 9,11,12 The webbased OSFP registry, administered by the French Federation of Pulmonology, contains anonymized longitudinal data from patients complaining of sleep disorders reported by respiratory physicians in private practice, general and university hospitals. Periodic quality controls ensure up-to-standard data recording.…”

Section: Methodsmentioning

confidence: 99%

“…Treatment-emergent CSA was associated with a higher risk of therapy discontinuation. 10 In this large real-life study using CPAP device-generated data, only age and gender were available and it was not possible to determine the role of co-morbidities, indices or OSA severity and the potential impact of various technical aspects of CPAP management 9,11,12 including that of interfaces. 13 Our hypothesis was that the underlying co-morbidities, especially cardiovascular diseases, lifestyle, OSA characteristics at diagnosis and type of interface, might explain persistent AHI > 5 during CPAP use.…”

Section: Introductionmentioning

confidence: 99%

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Partial failure of CPAP treatment for sleep apnoea: Analysis of the French national sleep database

et al. 2019

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Background and objective Continuous positive airway pressure (CPAP) is the first‐line therapy for obstructive sleep apnoea (OSA). Residual apnoea and/or hypopnoea events, that is an apnoea–hypopnoea index (AHI) > 5, during CPAP contribute to treatment drop‐out. The clinical scenarios triggering residual events during CPAP use are poorly described. Underlying co‐morbidities, especially cardiovascular diseases, lifestyle factors, OSA characteristics at diagnosis and type of mask have been suggested as potential contributors. Methods Patients from the prospective French sleep apnoea registry diagnosed with OSA (AHI ≥ 15 events/h) treated with CPAP were included. Logistic regression analysis identified factors associated with a risk of residual AHI > 5 events/h on CPAP. Results The 12 285 OSA patients were predominantly men (n = 8715, 70.9%), middle‐aged (58.2 (49.8; 66.1) years) and obese (median body mass index: 31.3 (27.7; 35.6) kg/m2). Most had an AHI ≤ 5 events/h (n = 9573, 77.9%) versus 22.1% with AHI > 5/h. The latter were less CPAP adherent (5.75 (4.01; 7.00) vs 6.00 (4.53; 7.00) h/night). In multivariable analysis, factors associated with residual AHI >5/h were male sex, age, sedentary lifestyle, OSA severity, cardiovascular co‐morbidities (heart failure and arrhythmia) and type of interface (orofacial mask versus nasal mask: OR = 2.15 (95%CI: 1.95; 2.37)). A subgroup analysis found that patients using pressures above 10 cm H2O were 1.43 (95% CI: 1.3; 1.57) times more likely to have residual AHI > 5/h. Conclusion Knowing about risk factors for residual apnoeic–hypopnoeic events may assist in the timely provision of personalized care including the type of PAP therapy, attention to co‐morbidities and choice of interface.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Partial failure of CPAP treatment for sleep apnoea: Analysis of the French national sleep database

et al. 2019

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“…Sleep apnea syndrome, mostly the obstructive type (OSAS), is a frequent comorbidity in acromegaly (reported mean, 69%, with a wide range, i.e . 27-100%) [ 55 ]; therefore all acromegaly patients should undergo a sleep study at diagnosis to be repeated during follow-up if pathological [ 53 , 56 ]. Sleep study should be quickly offered above all to symptomatic patients, patients with obesity or severe cardiovascular comorbidities, and patients at risk of accidents due to their work [ 57 , 58 ].…”

Section: Clinical Issuesmentioning

confidence: 99%

Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 1: Diagnostic and Clinical Issues

Cozzi

Ambrosio

Attanasio

et al. 2020

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: Acromegaly is a rare disease. Improvements in lifespan in these patients have recently been reported due to transsphenoidal surgery (TSS), advances in medical therapy, and tighter criteria for defining disease remission. This document reports the opinions of a group of Italian experts who have gathered together their prolonged clinical experience in the diagnostic and therapeutic challenges of acromegaly patients. Both GH and IGF-I (only IGF-I in those treated with Pegvisomant - PegV) are needed in the diagnosis and follow-up. Comorbidities (cardio-cerebrovascular disease, sleep apnea, metabolic derangement, neoplasms, and bone/joint disease) should be specifically addressed. Any newly diagnosed patient should be referred to a multidisciplinary team experienced in the treatment of pituitary adenomas.

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“…The estimated prevalence is 40 to 125 cases per million according to different epidemiological studies [ 4 – 8 ], but recent population based studies have shown that prevalence could be 5 to 15 times higher [ 9 – 13 ]. Schneider et al, in an unselected German population from a primary care center, found a prevalence of 1000 cases per million (1/1000) [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…The same authors showed that the probability of acromegaly in a hypertensive population without acral enlargement was very unlikely [ 12 ]. Recently, Galerneau et al described the prevalence of acromegaly in unselected patients with suspected sleep apnea-hypopnea syndrome (SAHS) and fount it to be 2.5/1000 [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of acromegaly in patients with symptoms of sleep apnea

et al. 2017

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Acromegaly is a rare disease with nonspecific symptoms with acral enlargement being almost universally present at diagnosis. The estimated prevalence is 40–125 cases/million but targeted universal screening studies have found a higher prevalence (about 10 fold). The aim of the ACROSAHS study was to investigate the prevalence of acromegaly and acromegaly comorbidities in patients with sleep apnea symptoms and acral enlargement. ACROSAHS was a Spanish prospective non-interventional epidemiological study in 13 Hospital sleep referral units. Facial and acral enlargement symptoms including: ring size and shoe size increase, tongue, lips and jaws enlargement, paresthesia or carpal tunnel syndrome and widening of tooth spaces, as well as other typical acromegaly comorbidities were recorded with a self-administered questionnaire of patients who attended a first visit for sleep apnea symptoms between 09/2013 and 07/2014. Serum insulin-like growth factor type 1 (IGF1) was measured in patients with ≥1 acral symptom to determine the prevalence of acromegaly. Of the 1557 patients enrolled, 1477 with complete data (72% male) were analyzed. 530 patients (36%) reported at least 1 acral enlargement symptom and were tested for IGF-1, 41 were above range, persisted in 7, and among those, 2 cases of acromegaly were diagnosed (prevalence of at least 1.35 cases/1000). Overall, 1019 patients (69%) had ≥2 acromegaly symptoms and should have been screened according to guidelines; moreover 373 patients (25%) had ≥1 symptom of acral enlargement plus ≥3 other acromegaly symptoms. In conclusion, in patients with sleep apnea symptoms and acral enlargement, we found an acromegaly prevalence of at least 1.35 cases per 1000 and a high prevalence of typical acromegaly symptoms. It is important that sleep specialists are aware of acromegaly symptoms to aid with acromegaly diagnosis.

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Acromegaly in sleep apnoea patients: a large observational study of 755 patients

Cited by 21 publications

References 14 publications

Partial failure of CPAP treatment for sleep apnoea: Analysis of the French national sleep database

Partial failure of CPAP treatment for sleep apnoea: Analysis of the French national sleep database

Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 1: Diagnostic and Clinical Issues

Prevalence of acromegaly in patients with symptoms of sleep apnea

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