Hypothyroidism in patients with obstructive sleep apnea syndrome

Year 2014, , 512 - 517, 01.09.2014

Sibel Ayık Melda Apaydın Saliha Aksun Galip Akhan Mithat Bahçeci

https://doi.org/10.5798/diclemedj.0921.2014.03.0464

Cited By: 1

Abstract

Objective: In this study, we aimed to search the possible association between Obstructive Sleep Apnea Syndrome\'s (OSAS) severity and thyroid gland malfunctions, and the effects of hypothyroidism on the mode of sleep in patients with OSAS. Methods: Demographic features and thyroid function tests of 211 patients (59, 28% female) with a mean age of 50.9 ± 10.4 years (ranging from 30 to 75) who underwent polysomnography between September 2010 and September 2011 were retrospectively evaluated. Results: Hypothyroidism was detected in 8.3% of the patients with simple snoring and 10.6% of those with OSAS (9.1% in mild OSAS, 20.3% in moderate OSAS and 6.3% in severe OSAS). There was no correlation between the severity of OSAS and the rate of hypothyroidism (p=0.620). The incidence of hypothyroidism was 16.9 % in women and 6.6% in men and this difference was statistically significant (p=0.024). The polysomnographic findings did not differ between the patients with hypothyroidism and the others (table 5). However, in patients with elevated TSH levels, the rate of desaturation during sleep was high despite a lower AHI (r=0.126, p=0.05). Conclusion: No correlation was seen between the severity of OSAS and the rate of hypothyroidism. Women with OSAS had higher incidence of hypothyroidism. The polysomnographic findings did not differ whether the patient had hypothyroidism or not. The rate of desaturation during sleep was relatively high in patients with elevated TSH levels.

Keywords

Sleep, apnea, hypothyroidism

Obstruktif uyku apne sendromlu olgularda hipotiroidi

Abstract

Amaç: Biz bu çalışmada; Obstruktif Uyku Apne Sendromu (OSAS) ağırlık şiddeti ile tiroid fonksiyon bozukluğu arasında bir ilişkinin olup olmadığını ve hipotiroidinin polisomnografik olarak OSAS\'lı olgularda uyku yapısı üzerine olan etkilerini araştırmayı amaçladık. Yöntemler: Eylül 2010- Eylül 2011 tarihleri arasında 30-75 yaş aralığında polisomnografi yapılan 211 olgunun (yaş ortalama 50,9± 10,4; 59\'u kadın (%28)) demografik özellikleri ve tiroid fonksiyon testleri (TFT) retrospektif olarak değerlendirildi. Bulgular: Hipotiroidi, basit horlama saptanan olgularda %8,3, OSAS\'lı olgularda (AHI≥5) %10,6 (hafif OSAS\'lı olgularda %9,1, orta OSAS\'lı olgularda %20,3 ve ağır OSAS\'lı olgularda %6,3) saptandı, OSAS ağırlık şiddetiyle hipotiroidi görülme sıklığı arasında belirgin bir ilişki izlenmedi (p=0.620). Kadın olgularda %16,9, erkek olgularda %6,6 hipotiroidi mevcuttu ve fark istatistiksel olarak anlamlıydı (p:0.024). Hipotiroidili olgular ile hipotiroidi saptanmayan olgularda polisomnografik bulgularda belirgin fark izlenmedi, fakat TSH yüksekliği olan olgularda AHI daha düşük olmasına rağmen, uykuda desatürasyon oranının daha yüksek olduğu gözlendi (r=0.126, p=0.05). Sonuç: Sonuç olarak hipotiroidi sıklığı OSAS ağırlık şiddetiyle belirgin değişiklik göstermemektedir. Kadın olgularda hipotiroidi daha sık gözlenmektedir. Hipotiroidi olan ve olmayan olgularda polisomnografik bulgularda belirgin fark izlenmemiştir. TSH yüksekliği olan olgularda uykuda desatürasyon oranın bir miktar daha yüksek olduğu gözlenmiştir.

Keywords

Uyku, apne, hipotiroidi

References

• Attal P, Chanson P. Endocrine aspects of obstructive sleep apnea. J Clin Endocrinol Metab 2010;95:483-495.
• Tunbridge WMG, Evered DC, Hall R, et al. The spectrum of thyroid disease in a community: The Whickam Survey, Clin Endocrinol 1977;7:481-493.
• Vanderpump MPJ, Tunbridge WMG, French JM, et al. The incidence of thyroid disorders in the community: A twenty- year follow up of the Whickam Survey. Clin Endocrinol 1995;43:55-69.
• Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Col- orado thyroid disease prevalence study. Arch Intern Med 2000;160:526-534.
• Winkelman JW, Goldman H, Piscatelli N, et al. Are thyroid function tests necessary in patients with suspected sleep ap- nea? Sleep 1996;19:790-793.
• Grunstein R, Obstructive sleep apnea syndrome and hypo- thyroidism. Chest 1994;105:1296-1267.
• Kapur VK, Koepsell TD, De Maine J, et al. Association of hypothyroidism and obstructive sleep apnea. Am J Respir Crit Care Med 1998;158:1379-1383.
• Miller CM, Husain AM. Should women with obstructive sleep apnea syndrome be screened for hypothyroidism? Sleep Breath 2003;7:185-188.
• Skjodt NM, Atkar R, Easton PA. Screening for hypo- thyroidism in sleep apnea. Am J Respir Crit Care Med 1999;160:732-735.
• American Academy of Sleep Medicine, Sleep-related breathing disorders in adults: recommendations for syn- drome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force., Sleep 1999;22:667-689.
• Iber C, Ancoli-Israel S, Chesson Jr AL, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1st ed, Westches- ter, Illinois: American Academy of Sleep Medicine;2007.
• American Academy of Sleep Medicine, International clas- sification of sleep disorders (ICSD): diagnostic and coding manual, 2nd ed, Westchester(IL): American Academy of Sleep Medicine;2005.
• Karakaş M S, Altekin R E, Baktır AO, ve ark. Obstrüktif uyku sendromu olan hastalarda hipotiroidi taramasi ya- pılmalı mı? Journal of Inonu University Medical Faculty 2011;18:4.
• Güven FS, Çiftçi B, Aydoğdu M, Obstrüktif uyku apne sendromu şüphesi olan olgularda hipotiroidi taraması ya- pılmalı mı? In: Çöplü L, Selçuk T, eds, Türk Toraks Der- neği VIII, Yıllık Kongre; 27 Nisan-1 Mayıs 2005; Antalya, Türkiye; 2005:6(Ek 1):176.
• Lin CC, Tsan KW, Chen PJ. The relationship between sleep apnea syndrome and hypothyroidism. Chest 1992;102:1663-1667.
• Winkelman JW, Goldman H, Piscatelli N, et al. Are thyroid function tests necessary in patients with suspected sleep ap- nea? Sleep 1996;19:790-793.
• Bahammam SA, Sharif MM, Jammah AA, Bahammam AS. Prevalence of thyroid disease in patients with obstructive sleep apnea, Respiratory Medicine 2011;105:1755-1760.
• Iglesias P, Díez JJ. Hypothyrodism in male patients: a de- scriptive, observational and cross-sectional study in a series of 260 men. Am J Med Sci 2008;336:315-320.
• Levy EG. Thyroid disease in the elderly. Med Clin North Am. 1991;751:151-167.
• Sawain CT, Castelli WP, Hershman JM, et al. The aging thyroid, Thyroid deficiency in the Framingham Study. Arch Intern Med 1985;145:1386–1388.
• Gül Ö, Şahin S, Cander S, Gül B, ve ark. Endokrinoloji po- likliniğine başvuran hastalarda tiroid fonksiyonlarının yaş ile olan ilişkisinin incelenmesi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2011;37:67-70.