Myxedema and obstructive sleep apnea

Three cases of hypersomnolence, snoring and documented sleep apnea are reported. All three patients were profoundly myxedematous, both clinically and biochemically. Polygraphic studies during sleep documented the presence of repetitive episodes of obstructive sleep apnea in all three patients. These were accompanied by arterial oxygen desaturation. After becoming euthyroid following the administration of the l-thyroxine all patients underwent a repeat evaluation in the sleep laboratory. These studies revealed nearly complete resolution of obstructive sleep apnea in all patients. In addition, several sleep parameters showed marked improvement. These data strongly suggest that the presence of profound daytime sleepiness in hypothyroid patients could be indicative of a potentially lethal complication of myxedema, obstructive sleep apnea.