What endocrine diseases are associated with Obstructive Sleep Apnea?
- The endocrine diseases commonly associated with OSA are hypothyroidism , acromegaly , and polycystic ovary syndrome (PCOS), but the most prevalent are obesity and T2DM .
- As would be expected, the statistics for these disorders vary, depending on the series.
- Although it was once thought that all patients with OSA had subclinical hypothyroidism, this has now been shown not to be the case. In general, 11% to 30% of patients with OSA will have subclinical or overt hypothyroidism, and the prevalence of OSA in patients with hypothyroidism is about 30%.
- OSA is reversible in the majority of such patients once they are treated appropriately with thyroid hormone replacement. In one prospective study of nonobese, middle-age men and women with newly diagnosed symptomatic hypothyroidism, 30% had OSA by PSG at study onset; 84% of those subjects had reversal of OSA with TSH normalization.
- Finally, insulin levels and measures of glucose tolerance in PCOS are strongly correlated with the risk and severity of OSA.
- Additionally, among those PCOS women with normal glucose tolerance, insulin levels are significantly higher in those at high versus low OSA risk, independent of BMI.
- Therefore, it is reasonable to assess measures of sleep habits and behaviors, and restorative sleep in all patients with PCOS.
- Probably the most alarming statistics are the prevalence of obesity and its partner in crime, T2DM.
- Using the older OSA diagnostic criteria, the prevalence of moderate-to-severe OSA in obese women and men age < 65 years, was 4% to 7% and 9% to 14%, respectively.
- More recent studies, using current diagnostic definitions, reported a substantially higher prevalence of moderate-to-severe OSA of 23% in obese women and 49% in obese men.
