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Disordered breathing during sleep in hypothyroidism.

J Skatrud, C Iber, R Ewart

    The American Review of Respiratory Disease
    |September 1, 1981
    PubMed
    Summary
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    This study found that hypothyroidism caused sleep apnea in a 58-year-old man. Treatment with L-thyroxine completely resolved his obstructive sleep apnea and oxygen desaturation, relieving his symptoms.

    Area of Science:

    • Endocrinology
    • Sleep Medicine
    • Pulmonary Medicine

    Background:

    • Obstructive sleep apnea (OSA) and oxygen desaturation can significantly impact patient health.
    • Hypothyroidism is a condition characterized by low thyroid hormone levels, potentially affecting respiratory function.

    Observation:

    • A 58-year-old male patient presented with symptoms of nocturnal obstructive apnea and oxygen desaturation.
    • Initial assessments revealed significantly low free thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels, indicative of hypothyroidism.
    • Despite normal pulmonary function and ventilatory responses, the patient experienced frequent apneic episodes and oxygen desaturation during sleep.

    Findings:

    • Medroxyprogesterone acetate (MPA) therapy reduced awake PaCO2 and improved ventilatory parameters, eliminating nocturnal apneas and desaturation.

    Related Experiment Videos

  • L-thyroxine therapy normalized thyroid hormone levels and completely resolved obstructive apnea and oxygen desaturation during sleep.
  • Both MPA and L-thyroxine treatments led to complete symptom relief for the patient.

    • Implications:

    • Sleep apnea syndrome can be a primary manifestation of hypothyroidism.
    • Thyroid hormone replacement therapy is crucial for managing hypothyroidism-related sleep disorders.
    • This case highlights the importance of evaluating thyroid function in patients with unexplained sleep apnea.