Sleep apnoea in endocrine diseases

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.