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Thyroid testing and thyroid hormone replacement in patients with sleep disordered breathing
S A Mickelson1, T Lian, L Rosenthal
1Atlanta Ear, Nose, and Throat Associates, Washington University School of Medicine, St. Louis, USA.
Ear, Nose, & Throat Journal
|November 2, 1999
Summary
This study found that hypothyroidism prevalence is similar in patients with sleep disordered breathing compared to the general population. Thyroid hormone replacement therapy showed minimal improvement for sleep apnea in hypothyroid patients.
Area of Science:
- Endocrinology
- Sleep Medicine
- Pulmonology
Background:
- Current literature suggests evaluating sleep disordered breathing (SDB) patients for hypothyroidism.
- Thyroid hormone replacement therapy is anecdotally reported to treat obstructive sleep apnea (OSA) in hypothyroid patients.
Purpose of the Study:
- To prospectively evaluate the prevalence of hypothyroidism in patients presenting for SDB evaluation.
- To examine the efficacy of hypothyroidism treatment on sleep apnea in patients with both conditions.
Main Methods:
- 1,000 consecutive patients evaluated for snoring or OSA.
- Routine thyroid testing performed on 834 patients.
- Polysomnography used to assess sleep apnea before and after thyroid hormone replacement therapy.
Main Results:
- 1.2% (10/834) of patients had undiagnosed clinical hypothyroidism.
- Four hypothyroid patients had OSA and received thyroid hormone replacement.
- No significant difference in respiratory disturbance index was observed post-treatment.
Conclusions:
- Hypothyroidism prevalence in SDB patients is not higher than in the general population.
- Thyroid replacement therapy offers little to no improvement for sleep apnea in clinical hypothyroidism.
- Routine thyroid function screening is not indicated for SDB evaluations.