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Obstructive sleep apnea syndrome and acromegaly
S A Mickelson1, L D Rosenthal, J P Rock
1Department of Otolaryngology, Henry Ford Hospital, Detroit, MI 48202.
Summary
Treating acromegaly, a condition causing growth hormone excess, can resolve obstructive sleep apnea. Addressing the pituitary tumor is key before considering airway surgery for sleep apnea in acromegalic patients.
Area of Science:
- Endocrinology
- Sleep Medicine
- Otolaryngology
Background:
- Obstructive sleep apnea syndrome (OSAS) is linked to upper airway abnormalities.
- In acromegaly, osseous and soft-tissue changes cause airway narrowing and collapse during sleep.
Purpose of the Study:
- To evaluate the treatment outcomes for patients with co-existing acromegaly and obstructive sleep apnea syndrome.
- To determine the efficacy of treating the underlying pituitary tumor versus surgical airway interventions.
Main Methods:
- Retrospective review of seven patients with acromegaly and OSAS.
- Treatment modalities included transsphenoidal hypophysectomy, radiation therapy, and uvulopalatopharyngoplasty.
Main Results:
- Four patients treated with hypophysectomy alone experienced OSAS resolution.
- One patient's apnea improved after hypophysectomy and radiation therapy.
- Five patients showed improved sleep breathing after successful acromegaly treatment.
Conclusions:
- Treating the pituitary tumor to reduce growth hormone levels is effective for OSAS in acromegaly.
- Prioritizing treatment of acromegaly can resolve sleep apnea, potentially avoiding airway surgeries.