Due to several factors, it is unclear whether continuous positive airway pressure (CPAP) treatment can improve symptoms associated with endocrine disorders in patients with obstructive sleep apnea (OSA). To further understand the observed bidirectional relationship between OSA and endocrine disorders, investigators conducted a medical evidence review that focused on the effects of treatment.
According to Maud Akset, Pulmonology, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), and his team, obesity, acromegaly (AM), and hypothyroidism are associated with obstructive sleep apnea. showed a frequent association of Moreover, OSA was improved and even cured in some cases when patients were treated for underlying endocrine disorders.
The estimated prevalence of moderate to severe obstructive sleep apnea in the United States is increasing and is now 13% in men aged 30-70 years and 6% in women in the same age range. However, European studies report rates of 30% and 13% in men and women, respectively.
Weight loss of 10% to 15% of body weight is known to be an effective method to improve OSA severity in obese men by approximately 50%. A study evaluating the impact of bariatric surgery on her OSA showed that in a study population of 13,900 patients, 78% to 90% of patients were able to improve or resolve their condition.
Patients over 50 years of age with AHI >30 or hypertension who experienced excessive weight loss were more likely to have persistent moderate-to-severe sleep apnea after surgery.
A recent systematic review showed that obstructive sleep apnea is estimated to be present in 25% to 50% of patients with overt (OH) hypothyroidism. The prevalence of disease in patients with asymptomatic (SCH) hypothyroidism is less clear.
Thyroid hormone replacement therapy generally normalizes thyroid function and improves BMI, subcutaneous fat thickness, blood glucose levels, and serum lipids, but improvements in obstructive sleep apnea have been reported in a few limited studies. This improvement was not provided in a recent study.
Obstructive sleep apnea in patients with well-controlled acromegaly has shown potential to improve OSA, although approximately 40% continue to show persistent OSA symptoms. According to the investigators, the patient population should be closely monitored by clinicians in parallel with polysomnography after initiation of acromegaly treatment.
Who should be screened for OSA?
Based on the evidence reviewed, the researchers found that type 2 diabetes, Cushing’s syndrome (CS), overt hypothyroidism, and acromegaly (not yet officially recommended but subject to investigation) ) patients were encouraged to undergo aggressive obstructive sleep apnea screening due to the presence of these disorders. Highest risk of complications.
“Although there is ample scientific debate about frank hypothyroidism, acromegaly, and diabetes as possible risk factors for OSA, primary aldosteronism (PA) and Cushing’s syndrome (CS),” he said. The investigator concluded.
Literature review “Endocrine disorders in obstructive sleep apnea syndrome: a two-way relationship” published Clinical Endocrinology.