Abstract
Amaç:
Obstruktif
uyku apne sendromu (OUAS); horlama, gündüz uyuklama, kilo fazlalığı, apati
ve/veya letarji gibi hipotiroidizmde de sıklıkla izlenebilen non-spesifik
semptomlarla ortaya çıkan bir klinik tablodur. Bu açıdan hipotiroidizm ile
ayırıcı tanısının dikkatli bir şekilde yapılması önemlidir.
Gereç
ve Yöntemler: Uykuda solunum bozuklukları ön tanısı ile
tüm gece PSG testine alınan 309 hastanın verileri retrospektif olarak
incelendi. Hastalara ait demografik veriler, vücut kile indeksleri, PSG
skorları ve tiroid fonksiyon test sonuçları derlendi.
Bulgular:
Tüm olguların genel yaş ortalaması 38.46 ± 12.34, vücut kitle indeksi (VKİ) ise
28.14 ± 4.08 olarak saptandı. Olguların 279’u (%90.3) erkek, 30’u (%9.7)
kadındı. Olguların 91’inde (%29.45) AHİ<5 olup bu olgular OUAS olmayan grup
olarak tanımlandı. 80 olguda (%25.89) hafif OUAS, 60’ında (%19.42) orta OUAS,
78’inde (%25.24) ise ağır OUAS saptandı (Tablo1). Tüm olguların tiroid
fonksiyon testleri incelendiğinde toplam 16 olguda (%5.59) hipotiroidizm
saptandı. Bu olguların 5’i OUAS olmayan grupta, 11’i ise OUAS saptanan
gruptaydı. OUAS olmayan grupta hipotiroidizm sıklığı %6.17 olarak izlenirken,
OUAS tanısı konulanlarda %5.36 oranında hipotiroidi görülmekteydi.
Sonuç:
Hipotiroidi saptanan olguların %50’sinin OUAS olmayan veya hafif OUAS grubunda
olmaları, tiroid fonksiyonlarının mutlaka incelenmesi gerekliliğini ortaya
koymaktadır. OUAS benzeri semptomlarla başvuran hastalarda kolay uygulanabilir
bir tarama yöntemi olan tiroid fonksiyon testlerinin yapılması klinik açıdan
önemli ve gereklidir.
Keywords
obstruktif uyku apne sendromu hipotiroidi tiroid fonksiyon testleri vücut kitle indeksi apne
References
- 1. Winkelman JW, Goldman H, Piscatelli N, et al. Are thyroid function tests necessary in patients with suspected sleep apnea? Sleep 1996;19:790-793.
- 2. Lin CC, Tsan KW, Chen PJ. The relationship between sleep apnea syndrome and hypothyroidism. Chest 1992; 102: 1663-7.
- 3. Popovici I, Khawaja I. Efficacy of thyroid function tests in patients suspected of having obstructive sleep apnea. Chest 1997; 112: 149.
- 4. Orr WC, Males JL, Imes NK. Myxedema and obstructive sleep apnea. Am J Med 1981; 70: 1061-66.
- 5. Dogan D, Ocal N, Aydogan M, Tasci C, Arslan Y, Tapan S, Yetkin S, Bilgic H. Assessment of the role of serum ischemia-modified albumin in obstructive sleep apnea in comparison with interleukin-6. Postgraduate Medicine. 2016 Aug;128(6):603-8.
- 6. 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 Oct;14(5):248e53.
- 7. WHO 2000 p. 6 Gray DS, Fujioka K (1991). "Use of relative weight and Body Mass Index for the determination of adiposity". J Clin Epidemiol 44 (6): 545–50.
- 8. Iglesias P, Díez JJ. Hypothyrodism in male patients: a descriptive, observational and cross-sectional study in a series of 260 men. Am J Med Sci 2008;336:315-320.
- 9. Bahammam SA, Sharif MM, Jammah AA, Bahammam AS. Prevalence of thyroid disease in patients with obstructive sleep apnea, Respiratory Medicine 2011;105:1755-1760.
- 10. Sawain CT, Castelli WP, Hershman JM, et al. The aging thyroid, Thyroid deficiency in the Framingham Study. Arch Intern Med 1985;145:1386–1388.
- 11. Prevalence of thyroid disease in patients with obstructive sleep apnea Salman A. Bahammam a , Munir M. Sharif b , Anwar A. Jammah c , Ahmed S. BaHammam. Respiratory Medicine (2011) 105, 1755e1760
- 12. Grunstein R. Obstructive sleep apnea syndrome and hypothyroidism. Chest 1994 Apr;105(4):1296e7. 13. 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 Nov;158(5 Pt 1): 1379e83.
- 14. Miller CM, Husain AM. Should women with obstructive sleep apnea syndrome be screened for hypothyroidism? Sleep Breath 2003 Dec;7(4):185e8.
- 15. Skjodt NM, Atkar R, Easton PA. Screening for hypothyroidism in sleep apnea. Am J Respir Crit Care Med 1999 Aug;160(2):732e5
- 16. Güven FS, Çiftçi B, Aydoğdu M. Obstrüktif uyku apne sendromu şüphesi olan olgularda hipotiroidi taraması yapılmalı mı? In: Çöplü L, Selçuk T, eds. Türk Toraks Derneği VIII. Yıllık Kongre; 27 Nisan-1 Mayıs 2005; Antalya, Türkiye; 2005:6 (Ek 1):176.
- 17. Karakaş MS, Altekin RE, Baktır AO, ve ark. Obstrüktif uyku sendromu olan hastalarda hipotiroidi taramasi yapılmalı mı? Journal of Inonu University Medical Faculty 2011;18:4.
- 18. Obstruktif uyku apne sendromlu olgularda hipotiroidi Hypothyroidism in patients with obstructive sleep apnea syndrome Sibel Ayık1 , Melda Apaydın2 , Saliha Aksun3 , Galip Akhan4 , Mithat Bahçeci. Dicle Tıp Derg / Dicle Med J. Cilt / Vol 41, No 3, 512-517
- 19. Özışık NÇ, Yurteri G, Tüzün B, Öztürk Ö, Oruç Ö. Obstruktif uyku apne sendromu olgularında hipotroidi taraması yapılmalı mı? S.D.Ü. Tıp Fak. Derg. 2008; 15: 18-22.
- 20. Doğan EG. Obstrüktif Uyku Apne Sendromlu Hastalarda Hipotiroidi Sıklığı (Tez). İstanbul: Sağlık Bakanlığı Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi; 2005.
Abstract
Objective: Obstructive sleep apnea syndrome (OSAS); is a
clinical condition that presented with non-specific symptoms that are
frequently seen in hypothyroidism such as snoring, daytime sleepiness, excess
weight, apathy and / or lethargy. In this respect, it is important that the
differential diagnosis is made carefully with hypothyroidism.
Material and Methods: We retrospectively reviewed the data of 309 patients
who underwent all night PSG test with pre-diagnosis of sleeping breathing
disorders. Demographic data, body mass index, PSG scores and thyroid function
test results were evaluated.
Results: The mean age of all cases was 38.46 ± 12.34 and the
body mass index (BMI) was 28.14 ± 4.08. Of all cases 279 (90.3%) were male and
30 (9.7%) were female. 91 (29.45%) cases had AHI <5 and defined as non-OSAS
group. Mild, moderate and severe OSAS were determined in 80 (25.89%) patients,
60 (19.42%) patients and 78 (25.24%) patients, respectively (Table 1). When
thyroid function tests were examined for entire group, hypothyroidism was
detected in 16 cases (5.59%). Of these 5 were in the group without OSAS and 11
were in the group with OSAS. Hypothyroidism frequency was 6.17% in the non-OSAS
group and 5.36% in the OSAS diagnosed group.
Conclusion: Our results demonstrated that 50% of the cases with
hypothyroidism were in the non-OSAS and mild OSAS group, necessitating the
evaluation of thyroid functions. Thyroid function tests, an easily applicable
screening method, is clinically important and necessary in patients presenting
with OSAS-like symptoms.
Keywords
obstructive sleep apnea syndrome hypothyroidism thyroid function tests body mass index apnea
References
- 1. Winkelman JW, Goldman H, Piscatelli N, et al. Are thyroid function tests necessary in patients with suspected sleep apnea? Sleep 1996;19:790-793.
- 2. Lin CC, Tsan KW, Chen PJ. The relationship between sleep apnea syndrome and hypothyroidism. Chest 1992; 102: 1663-7.
- 3. Popovici I, Khawaja I. Efficacy of thyroid function tests in patients suspected of having obstructive sleep apnea. Chest 1997; 112: 149.
- 4. Orr WC, Males JL, Imes NK. Myxedema and obstructive sleep apnea. Am J Med 1981; 70: 1061-66.
- 5. Dogan D, Ocal N, Aydogan M, Tasci C, Arslan Y, Tapan S, Yetkin S, Bilgic H. Assessment of the role of serum ischemia-modified albumin in obstructive sleep apnea in comparison with interleukin-6. Postgraduate Medicine. 2016 Aug;128(6):603-8.
- 6. 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 Oct;14(5):248e53.
- 7. WHO 2000 p. 6 Gray DS, Fujioka K (1991). "Use of relative weight and Body Mass Index for the determination of adiposity". J Clin Epidemiol 44 (6): 545–50.
- 8. Iglesias P, Díez JJ. Hypothyrodism in male patients: a descriptive, observational and cross-sectional study in a series of 260 men. Am J Med Sci 2008;336:315-320.
- 9. Bahammam SA, Sharif MM, Jammah AA, Bahammam AS. Prevalence of thyroid disease in patients with obstructive sleep apnea, Respiratory Medicine 2011;105:1755-1760.
- 10. Sawain CT, Castelli WP, Hershman JM, et al. The aging thyroid, Thyroid deficiency in the Framingham Study. Arch Intern Med 1985;145:1386–1388.
- 11. Prevalence of thyroid disease in patients with obstructive sleep apnea Salman A. Bahammam a , Munir M. Sharif b , Anwar A. Jammah c , Ahmed S. BaHammam. Respiratory Medicine (2011) 105, 1755e1760
- 12. Grunstein R. Obstructive sleep apnea syndrome and hypothyroidism. Chest 1994 Apr;105(4):1296e7. 13. 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 Nov;158(5 Pt 1): 1379e83.
- 14. Miller CM, Husain AM. Should women with obstructive sleep apnea syndrome be screened for hypothyroidism? Sleep Breath 2003 Dec;7(4):185e8.
- 15. Skjodt NM, Atkar R, Easton PA. Screening for hypothyroidism in sleep apnea. Am J Respir Crit Care Med 1999 Aug;160(2):732e5
- 16. Güven FS, Çiftçi B, Aydoğdu M. Obstrüktif uyku apne sendromu şüphesi olan olgularda hipotiroidi taraması yapılmalı mı? In: Çöplü L, Selçuk T, eds. Türk Toraks Derneği VIII. Yıllık Kongre; 27 Nisan-1 Mayıs 2005; Antalya, Türkiye; 2005:6 (Ek 1):176.
- 17. Karakaş MS, Altekin RE, Baktır AO, ve ark. Obstrüktif uyku sendromu olan hastalarda hipotiroidi taramasi yapılmalı mı? Journal of Inonu University Medical Faculty 2011;18:4.
- 18. Obstruktif uyku apne sendromlu olgularda hipotiroidi Hypothyroidism in patients with obstructive sleep apnea syndrome Sibel Ayık1 , Melda Apaydın2 , Saliha Aksun3 , Galip Akhan4 , Mithat Bahçeci. Dicle Tıp Derg / Dicle Med J. Cilt / Vol 41, No 3, 512-517
- 19. Özışık NÇ, Yurteri G, Tüzün B, Öztürk Ö, Oruç Ö. Obstruktif uyku apne sendromu olgularında hipotroidi taraması yapılmalı mı? S.D.Ü. Tıp Fak. Derg. 2008; 15: 18-22.
- 20. Doğan EG. Obstrüktif Uyku Apne Sendromlu Hastalarda Hipotiroidi Sıklığı (Tez). İstanbul: Sağlık Bakanlığı Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi; 2005.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | March 25, 2019 |
| Acceptance Date | September 4, 2018 |
| Published in Issue | Year 2019 Volume: 11 Issue: 1 |
