Indian Journal of Sleep Medicine

Register      Login

VOLUME 11 , ISSUE 4 ( October-December, 2016 ) > List of Articles

ORIGINAL ARTICLE

Association of Hypothyroidism in Obstructive Sleep Apnea Syndrome

Shailesh Kalamkar, Unnati D. Desai

Keywords : Apnea-hypopnea index (AHI), Polysomnography, Thyroid function tests (TFT), OSAS, Hypothyroid treatment.

Citation Information : Kalamkar S, Desai UD. Association of Hypothyroidism in Obstructive Sleep Apnea Syndrome. Indian Sleep Med 2016; 11 (4):145-150.

DOI: 10.5958/0974-0155.2016.00021.8

License: CC BY-SA 4.0

Published Online: 01-10-2016

Copyright Statement:  Copyright © 2016; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Hypothyroidism and obstructive sleep apnea syndrome (OSAS) are common comorbid conditions with overlapping clinical presentation. We decided to study the association of hypothyroidism in our OSAS patients. Methodology: This observational study included 108 patients with clinical features suggesting OSAS. The clinical details were noted; Polysomnography (PSG) and thyroid function tests (TFT) were done. Qualitative and quantitative data was analyzed with appropriate tests. Results: Seventy-two (66.7%) men and 36 (33.3%) women were included. PSG confirmed OSAS in 78 (72.2%). The severity of OSAS was mild, moderate, severe in 30 (38%), 28 (36%), 20 (26%) respectively. Thirteen (12%) had hypothyroidism; subclinical in 2 (15%) and clinical in 11 (85%). Only 2 (15%) were on optimal medical treatment. Hypothyroidism was seen in 11(14%) of OSAS, against in 2(7%) of the non-OSAS group. OSAS was found in 11(85%) of hypothyroid, against in 67 (71%) of the Euthyroid group. A statistically significant association between OSAS and hypothyroidism treatment was observed. Conclusion: The prevalence of hypothyroidism was higher in OSAS; though statistically insignificant. Association between OSAS and hypothyroidism treatment was statistically significant.


PDF Share
  1. Saxena S, Gothi D, Joshi JM. Prevalence of Symptoms and Risk of Sleep Disordered Breathing in Mumbai (India). Indian J Sleep Med 2006; 1.1: 27-31.
  2. Bilous RW, Tunbridge WM. The epidemiology of hypothyroidism-an update. Baillieres Clin Endocrinol Metab 1988; 2: 531-40.
  3. Massumi RA, Winnacker JL. Severe depression of the respiratory center in myxoedema. Am J Med 1964;36:876- 82.
  4. Sharma SK, Kumpawat S, Banga A, Goel A. Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi, India. Chest 2006; 130:149-56.
  5. Vijayan VK, Patial K. Prevalence of Obstructive Sleep Apnea Syndrome (OSAS) In Delhi, India. Chest 2006; 130: 92S.
  6. Lin CC, Tsan KW, Chen PJ. The relationship between sleep apnea syndrome and hypothyroidism. Chest 1992; 102: 1663-7.
  7. Meslier N, Giraud P, Person C, Badatcheff A, Racineux JL. Prevalence of hypothyroidism in sleep apnoea syndrome. Eur J Med 1992; 1: 437-8.
  8. Winkelman JW, Goldman H, Piscatelli N, Lukas SE, Dorsey CM, Cunningham S. Are thyroid function tests necessary in patients with suspected sleep apnea? Sleep 1996; 19: 790-793.
  9. Kapur VK, Koepsell TD, Demaine J, Hert, R, Sandblom, RE, Psaty BM. Association of hypothyroidism and obstructive sleep apnea. Am J Respir Crit Care Med 1998;158: 1379- 83.
  10. Skjodt NM, Atkar R, Easton PA. Screening for hypothyroidism in sleep apnea. Am J Respir Crit Care Med 1999; 160: 732-5.
  11. Resta O, Pannacciulli N, Di Gioia G, Stefano A, Barbaro MP, De Pergola G. High prevalence of previously unknown subclinical hypothyroidism in obese patients referred to a sleep clinic for sleep disordered breathing. Nutr Metab Cardiovasc Dis 2004; 14: 248-53.
  12. Sawin CT, Chopra D, Azizi F, Mannix JE, Bachaeach P. The Aging Thyroid: Increased Prevalence of Elevated Serum Thyrotropin Levels in the Elderly J Am Med Assoc 1979; 242: 247-50.
  13. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5: 136-43.
  14. Hiestand DM, Britz P, Goldman M, Phillips B. Prevalence of symptoms and risk of sleep apnea in the US population: Results from the national sleep foundation sleep in America 2005 poll. Chest 2006; 130: 780-6.
  15. Alotair H, Bahammam A. Gender differences in Saudi patients with obstructive sleep apnea. Sleep Breath 2008; 12: 323-9.
  16. Miller CM, Husain AM. Should women with obstructive sleep apnea syndrome be screened for hypothyroidism? Sleep Breath 2003; 7: 185-8.
  17. Pham CB, Shaughnessy AF. Should we treat subclinical hypothyroidism? BMJ 2008; 337: 290-291.
  18. Bahammam SA, Sharif MM, Jammah AA, Bahammam, AS. Prevalence of thyroid disease in patients with obstructive sleep apnea. Respir Med 2011; 105: 1755-1760.
  19. Jha A, Sharma SK, Tandon N, Lakshmy R, Kadhiravan T, Handa KK et al. Thyroxine replacement therapy reverses sleep-disordered breathing in patients with primary hypothyroidism. Sleep Med 2006; 7: 55-61.
  20. Rajagopal KR, Abbrecht PH, Derderian SS, Pickett C, Hofeldt F, Tellis CJ et al. Obstructive sleep apnea in hypothyroidism. Ann Intern Med 1984; 101: 491-4.
  21. Grunstein RR, Sullivan CE. Sleep apnea and hypothyroidism: mechanisms and management. Am J Med 1988; 85: 775-9.
  22. Resta O, Carratu P, Carpagnano GE, Maniscalco M, Di Gioia G, Lacedonia D, et al. Influence of subclinical hypothyroidism and T4 treatment on the prevalence and severity of obstructive sleep apnoea syndrome (OSAS). J Endocrinol Invest 2005; 28: 893-8.
  23. Shinno H, Inami Y, Inagaki T, Kawamukai T. Utani E, Nakamura Y, Horiguchi J. Successful treatment with levothyroxine for idiopathic hypersomnia patients with subclinical hypothyroidism. Gen Hosp Psychiatry 2009; 31: 190-3.
  24. Grunstein R, Wilcox I, Yang TS, Gould Y, Hedner J. Snoring and sleep apnoea in men: association with central obesity and hypertension. Int J Obes Relat Metab Disord 1993; 17: 533-40.
  25. Veasey SC, Guilleminault C, Strohl KP, Sanders MH, Ballard RD, Magalang U J. Medical therapy for obstructive sleep apnea: a review by the Medical Therapy for Obstructive Sleep Apnea Task Force of the Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep 2006; 29: 1036-44.
  26. Misiolek M, Marek B, Namyslowski G, Scierski W, Zwirska- Korczala K, Kazmierczak-Zagorska Z, et al. Sleep apnea syndrome and snoring in patients with hypothyroidism with relation to overweight. J Physiol Pharmacol 2007; 58(Suppl 1):77-85.
  27. Hira HS, Sibal L. Sleep apnea syndrome among patients with hypothyroidism. J Assoc Physicians India 1999; 47: 615-618.
  28. Mickelson SA, Lian T, Rosenthal L. Thyroid testing and thyroid hormone replacement in patients with sleep disordered breathing. Ear Nose Throat J 1999; 78: 768- 71.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.