Sleep apnea syndrome in endocrine clinics

Abstract

Obstructive sleep apnea syndrome (OSAS) is a chronic condition with a high prevalence (up to 7 % of the general population) characterized by frequent episodes of upper airway collapse while sleeping. Left untreated, OSAS can cause severe complications, including systemic hypertension, cardiovascular disease, stroke, and abnormal glucose metabolism. This review aims to summarize the close links between OSAS, endocrinology, and metabolism. In patients with metabolic syndrome, OSAS is an independent risk factor for the onset of type 2 diabetes and a worsening glycemic control. The accumulation of adipose tissue in the neck and limited chest wall dynamics, hypoxia, and local micro-inflammation link visceral obesity closely with OSAS. There is now an abundance of convincing data indicating that promoting lifestyle changes, improving sleep hygiene, and adjusting diet can ameliorate both metabolic syndrome and OSAS, especially in obese patients. The incidence of OSAS in acromegaly is high, though GH treatments seem to be unrelated to the onset of apnea in GH-deficient individuals. Prospective studies have suggested an association between hypertension and OSAS because intermittent nocturnal hypoxia prompts an increase in sympathetic tone, endothelial dysfunction, and vascular inflammation: aldosterone excess may have a pathophysiological role, and some authors have reported that treating OSAS leads to a modest, but significant, reduction in blood pressure.

MECHANISMS OF ENDOCRINOLOGY: Mechanisms of disease: the endocrinology of obstructive sleep apnoea

“…Moreover, hypercortisolism can induce UA myopathy leading to compromised UAs ( Fig. 6) (217,219,222).…”

Daytime sleepiness in patients with type 2 Diabetes Mellitus – a prospective cohort study

“…Obesity and obstructive sleep apnea (OSA) cooccur frequently with T2D [12,13]. Furthermore, short sleep duration increases the risk for the development of obesity [14] and is associated with increased incidence of T2D [15].…”

“…restless legs syndrome [7], obstructive sleep apnea [8], circadian alterations [9] and nervous system abnormalities [10,11]. Given these evidences, daytime sleepiness in diabetic patients are probably of multifactorial origin.Obesity and obstructive sleep apnea (OSA) cooccur frequently with T2D [12,13]. Furthermore, short sleep duration increases the risk for the development of obesity [14] and is associated with increased incidence of T2D [15].…”

Questionnaire-assessed risk of sleep apnea in inpatients with various endocrine disorders

“…Нарушения дыхания во сне играют немаловажную роль в развитии сердечно-сосудистых осложнений [1]. Вместе с тем в настоящее время имеются данные, подтверждающие связь апноэ сна и эндокринной патологии [2,3].…”

“…Риск развития апноэ сна при наличии ожирения повышается в 12-30 раз [11]. У больных акромегалией по данным некоторых исследований частота апноэ увеличивается до 80-95% [12][13][14][15], что связано прежде всего с гиперсекрецией соматотропного гормона (СТГ) и инсулиноподобного фактора роста 1 (ИФР-1), способствующих кранио-фасциальной деформации и гипертрофии языка, мягких тканей нёба, а также отеку слизистых оболочек верхних дыхательных путей [2,16]. При гипотиреозе основной причиной развития апноэ сна становится сужение верхних дыхательных путей вследствие инфильтрации мягких тканей глотки мукополисахаридами и белком [17].…”