The online version of this article (https://doi.org/10.1007/s12020-018-1694-1) contains supplementary material, which is available to authorized users.
Patients with acromegaly have an increased risk of sleep apnea, but reported prevalence rates vary largely. Here we aimed to evaluate the sleep apnea prevalence in a large national cohort of patients with acromegaly, to examine possible risk factors, and to assess the proportion of patients diagnosed with sleep apnea prior to acromegaly diagnosis.
Cross-sectional multicenter study of 259 Swedish patients with acromegaly. At patients’ follow-up visits at the endocrine outpatient clinics of all seven university hospitals in Sweden, questionnaires were completed to assess previous sleep apnea diagnosis and treatment, cardiovascular diseases, smoking habits, anthropometric data, and S-IGF-1 levels. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale. Patients suspected to have undiagnosed sleep apnea were referred for sleep apnea investigations.
Of the 259 participants, 75 (29%) were diagnosed with sleep apnea before the study start. In 43 (57%) of these patients, sleep apnea had been diagnosed before the diagnosis of acromegaly. After clinical assessment and sleep studies, sleep apnea was diagnosed in an additional 20 patients, yielding a total sleep apnea prevalence of 37%. Higher sleep apnea risk was associated with higher BMI, waist circumference, and index finger circumference. Sleep apnea was more frequent among patients with S-IGF-1 levels in the highest quartile.
Sleep apnea is common among patients with acromegaly, and is often diagnosed prior to their acromegaly diagnosis. These results support early screening for sleep apnea in patients with acromegaly and awareness for acromegaly in patients with sleep apnea.
J. Dal, U. Feldt-Rasmussen, M. Andersen, L.O. Kristensen, P. Laurberg, L. Pedersen, O.M. Dekkers, H.T. Sorensen, J.O. Jorgensen, Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study. Eur. J. Endocrinol. 175(3), 181–190 (2016). https://doi.org/10.1530/EJE-16-0117 CrossRefPubMed
F. Gatto, G. Trifiro, F. Lapi, F. Cocchiara, C. Campana, C. Dell’Aquila, C. Ferrajolo, M. Arvigo, C. Cricelli, M. Giusti, D. Ferone, Epidemiology of acromegaly in Italy: analysis from a large longitudinal primary care database. Endocrine (2018). https://doi.org/10.1007/s12020-018-1630-4 CrossRefPubMed
F.R. van Haute, G.F. Taboada, L.L. Correa, G.A. Lima, R. Fontes, A.P. Riello, M. Dominici, M.R. Gadelha, Prevalence of sleep apnea and metabolic abnormalities in patients with acromegaly and analysis of cephalometric parameters by magnetic resonance imaging. Eur. J. Endocrinol. 158(4), 459–465 (2008). https://doi.org/10.1530/eje-07-0753 CrossRefPubMed
T.J. Reid, K.D. Post, J.N. Bruce, M. Nabi Kanibir, C.M. Reyes-Vidal, P.U. Freda, Features at diagnosis of 324 patients with acromegaly did not change from 1981 to 2006: acromegaly remains under-recognized and under-diagnosed. Clin. Endocrinol. 72(2), 203–208 (2010). https://doi.org/10.1111/j.1365-2265.2009.03626.x CrossRef
M.E. Akkoyunlu, M.M. Ilhan, M. Bayram, E. Tasan, F. Yakar, H.K. Ozcelik, F. Karakose, L. Kart, Does hormonal control obviate positive airway pressure therapy in acromegaly with sleep-disordered breathing? Respir. Med. 107(11), 1803–1809 (2013). https://doi.org/10.1016/j.rmed.2013.08.043 CrossRefPubMed
N.M. Al Lawati, S.R. Patel, N.T. Ayas, Epidemiology, risk factors, and consequences of obstructive sleep apnea and short sleep duration. Prog. Cardiovasc. Dis. 51(4), 285–293 (2009). https://doi.org/10.1016/j.pcad.2008.08.001 CrossRefPubMed
A.K. Annamalai, A. Webb, N. Kandasamy, M. Elkhawad, S. Moir, F. Khan, K. Maki-Petaja, E.L. Gayton, C.H. Strey, S. O’Toole, S. Ariyaratnam, D.J. Halsall, A.N. Chaudhry, L. Berman, D.J. Scoffings, N.M. Antoun, D.P. Dutka, I.B. Wilkinson, J.M. Shneerson, J.D. Pickard, H.L. Simpson, M. Gurnell, A comprehensive study of clinical, biochemical, radiological, vascular, cardiac, and sleep parameters in an unselected cohort of patients with acromegaly undergoing presurgical somatostatin receptor ligand therapy. J. Clin. Endocrinol. Metab. 98(3), 1040–1050 (2013). https://doi.org/10.1210/jc.2012-3072 CrossRefPubMed
C. Castellani, G. Francia, L. Dalle Carbonare, M. Ferrari, E. Viva, R. Cerini, A. Zaccarella, L. Trevisiol, M.V. Davi, Morphological study of upper airways and long-term follow-up of obstructive sleep apnea syndrome in acromegalic patients. Endocrine 51(2), 308–316 (2016). https://doi.org/10.1007/s12020-015-0659-x CrossRefPubMed
D. Chemla, P. Attal, L. Maione, A.S. Veyer, G. Mroue, D. Baud, S. Salenave, P. Kamenicky, S. Bobin, P. Chanson, Impact of successful treatment of acromegaly on overnight heart rate variability and sleep apnea. J. Clin. Endocrinol. Metab. 99(8), 2925–2931 (2014). https://doi.org/10.1210/jc.2013-4288 CrossRefPubMed
M.V. Davi, L. Dalle Carbonare, A. Giustina, M. Ferrari, A. Frigo, V. Lo Cascio, G. Francia, Sleep apnoea syndrome is highly prevalent in acromegaly and only partially reversible after biochemical control of the disease. Eur. J. Endocrinol. 159(5), 533–540 (2008). https://doi.org/10.1530/eje-08-0442 CrossRefPubMed
D. Hernandez-Gordillo, R. Ortega-Gomez Mdel, L. Galicia-Polo, A. Castorena-Maldonado, A. Vergara-Lopez, M.A. Guillen-Gonzalez, L. Torre-Bouscoulet, Sleep apnea in patients with acromegaly. Frequency, characterization and positive pressure titration. Open Respir. Med. J. 6, 28–33 (2012). https://doi.org/10.2174/1874306401206010028 CrossRefPubMedPubMedCentral
K.A. Franklin, E. Lindberg, Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J. Thorac. Dis. 7(8), 1311–1322 (2015). https://doi.org/10.3978/j.issn.2072-1439.2015.06.11 CrossRefPubMedPubMedCentral
S. Javaheri, F. Barbe, F. Campos-Rodriguez, J.A. Dempsey, R. Khayat, S. Javaheri, A. Malhotra, M.A. Martinez-Garcia, R. Mehra, A.I. Pack, V.Y. Polotsky, S. Redline, V.K. Somers, Sleep apnea: types, mechanisms, and clinical cardiovascular consequences. J. Am. Coll. Cardiol. 69(7), 841–858 (2017). https://doi.org/10.1016/j.jacc.2016.11.069 CrossRefPubMedPubMedCentral
F. Valham, T. Mooe, T. Rabben, H. Stenlund, U. Wiklund, K.A. Franklin, Increased risk of stroke in patients with coronary artery disease and sleep apnea: a 10-year follow-up. Circulation 118(9), 955–960 (2008). https://doi.org/10.1161/CIRCULATIONAHA.108.783290 CrossRefPubMed
E. Lesen, D. Granfeldt, A. Houchard, J. Dinet, A. Berthon, D.S. Olsson, I. Bjorholt, G. Johannsson, Comorbidities, treatment patterns and cost-of-illness of acromegaly in Sweden: a register-linkage population-based study. Eur. J. Endocrinol. 176(2), 203–212 (2017). https://doi.org/10.1530/EJE-16-0623 CrossRefPubMed
E. De Menis, A. Giustina, A. Colao, E. Degli Uberti, E. Ghigo, F. Minuto, F. Bogazzi, R. Drigo, A. Cattaneo, G. Aimaretti, Assessment of the awareness and management of sleep apnea syndrome in acromegaly. The COM.E.TA (Comorbidities Evaluation and Treatment in Acromegaly) Italian Study Group. J. Endocrinol. Invest. 34(1), 60–64 (2011) CrossRefPubMed
L. Vannucci, P. Luciani, E. Gagliardi, S. Paiano, R. Duranti, G. Forti, A. Peri, Assessment of sleep apnea syndrome in treated acromegalic patients and correlation of its severity with clinical and laboratory parameters. J. Endocrinol. Invest. 36(4), 237–242 (2013). https://doi.org/10.3275/8513 CrossRefPubMed
L.M. Galerneau, J.L. Pepin, A.L. Borel, O. Chabre, M. Sapene, B. Stach, J. Girey-Rannaud, N. Arnol, R. Tamisier, P. Caron, scientific, c., investigators of the French national sleep apnoea, r.: Acromegaly in sleep apnoea patients: a large observational study of 755 patients. Eur. Respir. J. 48(5), 1489–1492 (2016). https://doi.org/10.1183/13993003.01229-2016 CrossRefPubMed
G. Sesmilo, E. Resmini, M. Sambo, C. Blanco, F. Calvo, F. Pazos, P. Fernandez-Catalina, P. Martinez de Icaya, C. Paramo, C. Fajardo, M. Marazuela, C. Alvarez-Escola, J.J. Diez, V. Perea; group, A.s., Prevalence of acromegaly in patients with symptoms of sleep apnea. PLoS One 12(9), e0183539 (2017). https://doi.org/10.1371/journal.pone.0183539 CrossRefPubMedPubMedCentral
D.A. Heinrich, C. Reinholz, M. Bauer, A. Tufman, R. Frohner, J. Schopohl, M. Bidlingmaier, R.P. Kosilek, M. Reincke, H.J. Schneider, IGF-1-based screening reveals a low prevalence of acromegaly in patients with obstructive sleep apnea. Endocrine 60(2), 317–322 (2018). https://doi.org/10.1007/s12020-018-1538-z CrossRefPubMed
A.J. van der Lely, R. Gomez, A. Pleil, X. Badia, T. Brue, M. Buchfelder, P. Burman, D. Clemmons, E. Ghigo, J.O.L. Jorgensen, A. Luger, J. van der Lans-Bussemaker, S.M. Webb, C.J. Strasburger, Development of ACRODAT(R), a new software medical device to assess disease activity in patients with acromegaly. Pituitary 20(6), 692–701 (2017). https://doi.org/10.1007/s11102-017-0835-5 CrossRefPubMedPubMedCentral
J. Duran, S. Esnaola, R. Rubio, A. Iztueta, Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am. J. Respir. Crit. Care Med. 163(3 Pt 1), 685–689 (2001). https://doi.org/10.1164/ajrccm.163.3.2005065 CrossRefPubMed
P.V. Tishler, E.K. Larkin, M.D. Schluchter, S. Redline, Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleep-disordered breathing. JAMA 289(17), 2230–2237 (2003). https://doi.org/10.1001/jama.289.17.2230 CrossRefPubMed
- Temporal relationship of sleep apnea and acromegaly: a nationwide study
Karl A. Franklin
Jenny Tiberg Persson
Britt Edén Engström
- Springer US
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