Relationship between obstructive sleep apnea syndrome and thyroid diseases
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ORIGINAL ARTICLE
Relationship between obstructive sleep apnea syndrome and thyroid diseases Turkan Mete • Yavuz Yalcin • Dilek Berker • Bulent Ciftci • Selma Guven Firat • Oya Topaloglu Halise Cinar Yavuz • Serdar Guler
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Received: 14 December 2012 / Accepted: 12 March 2013 Ó Springer Science+Business Media New York 2013
Abstract Obstructive sleep apnea syndrome (OSAS) is a widespread disorder characterized by recurrent, partial, or complete episodes of apnea due to upper airway tract obstruction during sleep. OSAS frequency is likely to increase in hypothyroidism because of obesity, macroglossia, dysfunctional upper respiratory tractus (URT) musculature, deposition of mucopolysaccharides in URT tissues, and decreased ventilatory control. This study examines the relationship between OSAS and thyroid disease in OSAS subjects. This study includes 150 polysomnographically diagnosed OSAS patients (50 mild, 50 moderate, 50 severe OSAS cases) treated at Endocrinology and Metabolism Department of Ankara Numune Training and Research Hospital between January 2010 and May 2011 and 32 non-OSAS control subjects. All patients were given serum TSH, free T3 (fT3), free T4 (fT4), anti thyroid peroxidase (Anti-TPO), and anti-thyroglobulin (anti-TG) tests, as well as thyroid ultrasounds. We did not find any difference in prevalence of hypothyroidism, numbers of nodules and parenchyma heterogenicity determined by ultrasound, between OSAS subgroups and controls (p [ 0,05). In this study, functional and ultrasonographic examination of the thyroid gland did not reveal any relationship between OSAS and thyroid disease. We believe hence that long-term follow-up studies can establish the
T. Mete (&) Y. Yalcin D. Berker O. Topaloglu H. Cinar Yavuz S. Guler Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Training and Research Hospital, Ankara, Turkey e-mail: [email protected] B. Ciftci S. Guven Firat Sleep Disorders Center, Atatu¨rk Chest Diseases, Thoracic Surgery Training and Research Hospital, Ankara, Turkey
possible significance of routine evaluation of OSAS patients for thyroid disease. Keywords Obstructive sleep apnea syndrome (OSAS) Thyroid disease Hypothyroidism Thyroid function tests
Introduction Obstructive sleep apnea syndrome (OSAS) is a common disorder characterized by recurrent, partial or complete upper respiratory tractus (URT) obstruction, episodic apnea, and increased respiratory effort during sleep. Its prevalence in middle aged people is found to be 4 % in males and 2 % in females. Nevertheless, 26 % of adults are under high risk for OSAS [1]. OSAS is a syndrome with metabolic and endocrinological complications. It has been suggested that OSAS affects the hypothalamic–pituitary–adrenal axis (HPA) as it causes hypoxic episodes and sleep disruption. A study on the effect of continuous positive airway pressure (CPAP) on salivary cortisol as an index of physiologic stress related to sleepiness and OSAS suggested that active treatment in CPAP users temporarily reduced t
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