Sleep apnoea in endocrine diseases

Rosenow, Felix; McCarthy, Vincent P.; Caruso, A.

doi:10.1046/j.1365-2869.1998.00086.x

Cited by 90 publications

(66 citation statements)

References 7 publications

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“…Interestingly, a number of maternal factors have been reported to increase the likelihood of developing pre-eclampsia [9], including obesity, insulin resistance, hypertension, and elevated plasma homocysteine levels. Several of these factors are also associated with the development of OSAS [15].…”

Section: Discussionmentioning

confidence: 99%

Inspiratory flow limitation during sleep in pre-eclampsia: comparison with normal pregnant and nonpregnant women

Connolly

Razak²,

Hayanga³

et al. 2001

Eur Respir J

107

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Self-reported snoring is common in pregnancy, particularly in females with pre-eclampsia. The prevalence of inspiratory flow limitation during sleep in pre-eclamptic females was objectively assessed and compared with normal pregnant and nonpregnant females.Fifteen females with pre-eclampsia were compared to 15 females from each of the three trimesters of pregnancy, as well as to 15 matched nonpregnant control females (total study population, 75 subjects). All subjects had overnight monitoring of respiration, oxygen saturation, and blood pressure (BP).No group had evidence of a clinically significant sleep apnoea syndrome, but patients with pre-eclampsia spent substantially more time (31±8.4% of sleep period time, mean±sd) with evidence of inspiratory flow limitation compared to 15.5±2.3% in third trimester subjects and <5% in the other three groups (p=0.001). In the majority of pre-eclamptics, the pattern of flow limitation was of prolonged episodes lasting several minutes without associated oxygen desaturation. As expected, systolic and diastolic BPs were significantly higher in the pre-eclamptic group (p<0.001), but all groups showed a significant fall (p≤0.05) in BP during sleep.Inspiratory flow limitation is common during sleep in patients with pre-eclampsia, which may have implications for the pathophysiology and treatment of this disorder.

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Section: Discussionmentioning

confidence: 99%

Inspiratory flow limitation during sleep in pre-eclampsia: comparison with normal pregnant and nonpregnant women

Connolly

Razak²,

Hayanga³

et al. 2001

Eur Respir J

107

View full text Add to dashboard Cite

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“…The operative team should be aware of the risks of performing the transsphenoidal adenoma resection in acromegalic patients with sleep apnoea in whom upper airway oedema could potentially further aggravate gas exchange postoperatively [67]. Octreotide treatment may promptly alleviate OSAS, and thus its preoperative administration is recommended [72,[75][76][77]. Preoperative nasal CPAP therapy could also reduce the perioperative risks [77].…”

Section: Acromegalymentioning

confidence: 99%

“…Octreotide treatment may promptly alleviate OSAS, and thus its preoperative administration is recommended [72,[75][76][77]. Preoperative nasal CPAP therapy could also reduce the perioperative risks [77]. Sedatives have to be avoided and monitoring of breathing should be extended beyond the immediate postoperative period.…”

Section: Acromegalymentioning

confidence: 99%

Sleep-disordered breathing and hormones

Saaresranta¹,

Polo²

2003

Eur Respir J

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Sleep-disordered breathing (SDB) is not only a problem of the upper airway but is a systemic condition with endocrine and metabolic interactions. The accumulating body of evidence shows that SDB induces changes in the serum levels or secretory patterns of several hormones. Conversely, various endocrine disorders and hormone therapies may induce, exacerbate or alleviate SDB.Much of the understanding of the interactions between hormones and sleepdisordered breathing derive from intervention studies with nasal continuous positive airway pressure therapy. Better understanding of hormones and breathing may open new perspectives in developing strategies to prevent, alleviate or cure sleep-disordered breathing and its systemic consequences. Eur Respir J 2003; 22: 161-172.

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“…Some authors describe a prompt reversal of symptoms, sleep-disordered breathing, and nocturnal hypoxia [12], while little or no improvement in sleep apnea is reported by others [10]. Nocturnal Continuous Positive Airway Pressure (nCPAP) treatment can be necessary initially and in some patients even after remission of clinical signs of hypothyroidism [11].…”

mentioning

confidence: 99%

Sleep apnea syndrome and hypothyroidism

Lanfranco

2013

Endocrine

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Obstructive sleep apnea syndrome (OSAS) is a serious, prevalent condition that has significant mortality and morbidity when untreated. It is strongly associated with obesity and is characterized by several endocrine and metabolic abnormalities that are frequently more marked than those in obese patients without OSAS, suggesting that factors other than obesity per se have a role in this clinical condition [6]. Obese patients with OSAS show alterations in the GH/IGF-I axis function, PRL secretion, HPA axis and gonadal axis activity. Some derangement in TSH secretion in obesity with or without OSAS has been demonstrated by some authors, whereas a normal thyroid activity has been described by others [5,6].The study by Mete and colleagues published on Endocrine in April 2013 examined the relationship between OSAS and thyroid disease. Functional and ultrasonographic examination of the thyroid gland was performed in 150 polysomnographically diagnosed OSAS patients and in 32 control subjects. Aim of the study was to evaluate both thyroid function and thyroid nodule frequency and parenchyma heterogenecity in OSAS patients. The morphologic evaluation of the thyroid gland is peculiar of this study in comparison to other investigations. In fact, regardless of hypothyroidism, large goiters alone can cause pharynx occlusion and thus OSAS. The authors did not find any difference in prevalence of hypothyroidism, numbers of nodules, and parenchyma heterogenecity determined by ultrasound, between OSAS subgroups and controls. Thus this study did not reveal any relationship between OSAS and thyroid disease. The authors concluded that long-term follow-up studies are needed to establish the possible significance of routine evaluation of OSAS patients for thyroid disease [9].As a matter of fact, the incidence of thyroid deficiency states in patients with OSAS is not clearly known, thus the opportunity to evaluate thyroid function in all patients with the syndrome is still debated.It is well known that OSAS and hypothyroidism have several common signs that create a significant risk of undiagnosed hypothyroidism in OSAS. On the other hand, the suspect of sleep apnea in hypothyroid patients, especially when obese and with persistent sleep-disordered breathing during appropriate replacement therapy, should be taken into account.Endocrinologists and professionals dealing with sleep disturbances and OSAS should bear in mind that hypothyroidism may cause OSAS and that OSAS may be linked to (or even cause) hypothyroidism.A link between hypothyroidism and OSAS is suggested by the high prevalence of sleep apnea among hypothyroid patients, particularly in rare myxedematous cases [3,7]. The increased prevalence of OSAS appears to be related to obesity and male sex rather than to hypothyroidism per se, although decreased ventilatory responses, extravasation of albumin, and mucopolysaccharides in the tissues of the upper airway and hypothyroid myopathy have been suggested as possible contributing factors for OSAS in hypothyroidism [3]. Moreover, co...

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Sleep apnoea in endocrine diseases

Cited by 90 publications

References 7 publications

Inspiratory flow limitation during sleep in pre-eclampsia: comparison with normal pregnant and nonpregnant women

Inspiratory flow limitation during sleep in pre-eclampsia: comparison with normal pregnant and nonpregnant women

Sleep-disordered breathing and hormones

Sleep apnea syndrome and hypothyroidism

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