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Sleep apnoea in endocrine diseases

F Rosenow1, V McCarthy, A C Caruso

  • 1Section of Epilepsy and Sleep Disorders, The Cleveland Clinic Foundation, USA.

Journal of Sleep Research
|June 5, 1998
PubMed
Summary

Sleep apnoea (SA) is more prevalent in endocrine diseases like acromegaly and hypothyroidism. Treatment of the underlying endocrine condition is key, but continuous positive airway pressure (CPAP) is often necessary.

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Area of Science:

  • Endocrinology
  • Sleep Medicine
  • Internal Medicine

Background:

  • Sleep apnoea (SA) is increasingly recognized in patients with various endocrine disorders.
  • Hormonal imbalances can significantly impact respiratory control and airway patency.
  • Understanding the link between endocrine diseases and SA is crucial for comprehensive patient management.

Purpose of the Study:

  • To review the literature on the prevalence, clinical features, and pathogenic mechanisms of sleep apnoea in acromegaly, Cushing syndrome, hypothyroidism, and diabetes mellitus.
  • To synthesize current knowledge on the relationship between specific endocrine conditions and sleep apnoea.
  • To identify gaps in research regarding the pathogenesis and prevalence of SA in endocrine diseases.

Main Methods:

  • A comprehensive literature review was conducted.
  • Pertinent studies on sleep apnoea in acromegaly, Cushing syndrome, hypothyroidism, and diabetes mellitus were analyzed.
  • Data on prevalence, clinical manifestations, and pathogenic mechanisms were extracted and synthesized.

Main Results:

  • Increased SA prevalence is documented in acromegaly, linked to tissue hypertrophy and potentially central respiratory control changes.
  • Hypothyroidism, particularly with myxedema, shows higher SA rates, with edema and myopathy as contributing factors; thyroxine therapy can be effective.
  • In Cushing syndrome, parapharyngeal fat accumulation may cause SA, though data is limited. Obesity is a risk factor for SA in non-insulin-dependent diabetes mellitus (NIDDM), while autonomic neuropathy is implicated in insulin-dependent diabetes mellitus (IDDM).

Conclusions:

  • Sleep apnoea is a significant comorbidity in several endocrine diseases.
  • Pathogenesis varies, involving peripheral obstruction, central respiratory changes, tissue edema, fat accumulation, and autonomic neuropathy.
  • Effective management often requires treating the underlying endocrine disorder, with nasal continuous positive airway pressure (nCPAP) as a primary treatment option when needed. Further prospective studies are essential.

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