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Relationship between sleep apnea and thyroid function

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An Erratum to this article was published on 02 September 2014

Abstract

Purpose

Sleep apnea is sometimes associated with hypothyroidism, but the significance of thyroid function screening in sleep apnea patients has been controversial. In the present study, we investigated the relationship between thyroid function and sleep apnea in subjects who were suspected to have sleep apnea.

Methods

We enrolled 156 consecutive subjects suspected of having sleep apnea. Subjects included 117 men and 39 women aged 21 to 84 years. They underwent nocturnal multichannel polysomnography during a one-night hospitalization. The examined indices of sleep apnea were apnea–hypopnea index (AHI), lowest oxygen saturation, oxygen desaturation index, longest apnea duration, mean apnea duration, and the percent of apnea time to sleep time. Serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were concomitantly measured by electrochemiluminescence immunoassays.

Results

Three subjects (1.9 %) were diagnosed with primary hypothyroidism (high TSH and low FT4), and one subject (0.6 %) with subclinical hypothyroidism (high TSH and normal FT4). No significant difference in the level of TSH, FT3, or FT4 was seen among subjects with different severity of sleep apnea. The mean apnea duration significantly correlated with TSH in both simple and multiple regression analyses. Subjects with lower FT3 (≤3.75 pg/ml) showed longer mean apnea time compared to those with higher FT3 (>3.75 pg/ml) (24.9 ± 0.8 vs. 20.2 ± 1.2 s; P = 0.009). The other indices of sleep apnea did not show significant correlation with thyroid function.

Conclusions

These results suggest that the mean apnea duration and TSH/FT3 may be helpful in understanding reciprocity between the two disease states, and for evaluating the validity of thyroid function tests in patients with sleep apnea.

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References

  1. Rajagopal KR, Abbrecht PH, Derderian SS, Pickett C, Hofeldt F, Tellis CJ, Zwillich CW (1984) Obstructive sleep apnea in hypothyroidism. Ann Intern Med 101:491–494

    Article  CAS  PubMed  Google Scholar 

  2. Kittle WM, Chaudhary BA (1988) Sleep apnea and hypothyroidism. South Med J 81:1421–1425

    Article  CAS  PubMed  Google Scholar 

  3. Grunstein RR, Sullivan CE (1988) Sleep apnea and hypothyroidism: mechanisms and management. Am J Med 85:775–779

    Article  CAS  PubMed  Google Scholar 

  4. Pelttari L, Rauhala E, Polo O, Hyyppa MT, Kronholm E, Viikari J, Kantola I (1994) Upper airway obstruction in hypothyroidism. J Int Med 236:177–181

    Article  CAS  Google Scholar 

  5. Lin CC, Tsan KW, Chen PJ (1992) The relationship between sleep apnea syndrome and hypothyroidism. Chest 102:1663–1667

    Article  CAS  PubMed  Google Scholar 

  6. Kapur VK, Koepsell TD, deMaine J, Hert R, Sandblom RE, Psaty BM (1998) Association of hypothyroidism and obstructive sleep apnea. Am J Respir Crit Care Med 158:1379–1383

    Article  CAS  PubMed  Google Scholar 

  7. Mickelson SA, Lian T, Rosenthal L (1999) Thyroid testing and thyroid hormone replacement in patients with sleep disordered breathing. Ear Nose Throat J 78:768–775

    CAS  PubMed  Google Scholar 

  8. Miller CM, Husain AM (2003) Should women with obstructive sleep apnea syndrome be screened for hypothyroidism? Sleep Breath 7:185–188

    Article  PubMed  Google Scholar 

  9. Resta O, Pannacciulli N, Di Gioia G, Stefano A, Barbaro MP, De Pergola G (2004) High prevalence of previously unknown subclinical hypothyroidism in obese patients referred to a sleep clinic for sleep disordered breathing. Nutr Metab Cardiovasc Dis 14:248–253

    Article  CAS  PubMed  Google Scholar 

  10. Sakellaropoulou AV, Hatzistilianou MN, Emporiadou MN, Aivazis VT, Rousso I, Athanasiadou-Piperopoulou F (2011) Evaluation of thyroid gland function in children with obstructive apnea hypopnea syndrome. Int J Immunopathol Pharmacol 24:377–386

    CAS  PubMed  Google Scholar 

  11. Bahammam SA, Sharif MM, Jammah AA, Bahammam AS (2011) Prevalence of thyroid disease in patients with obstructive sleep apnea. Respir Med 105:1755–1760

    Article  PubMed  Google Scholar 

  12. Rechtschaffen A, Kales A (1968) A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. University of California, Brain Information Service/Brain Research Institute, Los Angeles

    Google Scholar 

  13. Iber C, Ancoli-Israel S, Chesson A, Quan SF (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. American Academy of Sleep Medicine, Westchester

    Google Scholar 

  14. Jha A, Sharma SK, Tandon N, Lakshmy R, Kadhiravan T, Handa KK, Gupta R, Pandey RM (2006) Thyroxine replacement therapy reverses sleep-disordered breathing in patients with primary hypothyroidism. Sleep Med 7:55–61

    Article  PubMed  Google Scholar 

  15. Winkelman JW, Goldman H, Piscatelli N, Lukas SE, Dorsey CM, Cunningham S (1996) Are thyroid function tests necessary in patients with suspected sleep apnea? Sleep 19:790–793

    CAS  PubMed  Google Scholar 

  16. Resta O, Carratu P, Carpagnano GE, Maniscalco M, Di Gioia G, Lacedonia D, Giorgino R, De Pergola G (2005) Influence of subclinical hypothyroidism and T4 treatment on the prevalence and severity of obstructive sleep apnoea syndrome (OSAS). J Endocrinol Invest 28:893–898

    Article  CAS  PubMed  Google Scholar 

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There is no actual or potential conflict of interest in relation to this work.

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan

    Shoko Takeuchi, Takuro Kitamura, Toyoaki Ohbuchi, Hiroki Koizumi, Risa Takahashi, Nobusuke Hohchi & Hideaki Suzuki

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  1. Shoko Takeuchi
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  2. Takuro Kitamura
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  3. Toyoaki Ohbuchi
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  4. Hiroki Koizumi
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  5. Risa Takahashi
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  6. Nobusuke Hohchi
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  7. Hideaki Suzuki
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Corresponding author

Correspondence to Hideaki Suzuki.

Additional information

Shoko Takeuchi and Hideaki Suzuki equally contributed to this work.

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Takeuchi, S., Kitamura, T., Ohbuchi, T. et al. Relationship between sleep apnea and thyroid function. Sleep Breath 19, 85–89 (2015). https://doi.org/10.1007/s11325-014-0966-0

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