Sibel AYIK, Melda APAYDIN, SALİHA AKSUN, Galip AKHAN, Mithat BAHCECİ

Obstruktif uyku apne sendromlu olgularda hipotiroidi

Amaç: Biz bu çalışmada; Obstruktif Uyku Apne Sendromu (OSAS) ağırlık şiddeti ile tiroid fonksiyon bozukluğu arasında bir ilişkinin olup olmadığını ve hipotiroidinin polisomnografik olarak OSASlı olgularda uyku yapısı üzerine olan etkilerini araştırmayı amaçladık. Yöntemler: Eylül 2010- Eylül 2011 tarihleri arasında 30- 75 yaş aralığında polisomnografi yapılan 211 olgunun (yaş ortalama 50,9± 10,4; 59u kadın (%28)) demografik özellikleri ve tiroid fonksiyon testleri (TFT) retrospektif olarak değerlendirildi. Bulgular: Hipotiroidi, basit horlama saptanan olgularda %8,3, OSASlı olgularda (AHI≥5) %10,6 (hafif OSASlı olgularda %9,1, orta OSASlı olgularda %20,3 ve ağır OSASlı olgularda %6,3) saptandı, OSAS ağırlık şiddetiyle hipotiroidi görülme sıklığı arasında belirgin bir ilişki izlenmedi (p=0.620). Kadın olgularda %16,9, erkek olgularda %6,6 hipotiroidi mevcuttu ve fark istatistiksel olarak anlamlıydı (p:0.024). Hipotiroidili olgular ile hipotiroidi saptanmayan olgularda polisomnografik bulgularda belirgin fark izlenmedi, fakat TSH yüksekliği olan olgularda AHI daha düşük olmasına rağmen, uykuda desatürasyon oranının daha yüksek olduğu gözlendi (r=0.126, p=0.05). Sonuç: Sonuç olarak hipotiroidi sıklığı OSAS ağırlık şiddetiyle belirgin değişiklik göstermemektedir. Kadın olgularda hipotiroidi daha sık gözlenmektedir. Hipotiroidi olan ve olmayan olgularda polisomnografik bulgularda belirgin fark izlenmemiştir. TSH yüksekliği olan olgularda uykuda desatürasyon oranın bir miktar daha yüksek olduğu gözlenmiştir.

Hypothyroidism in patients with obstructive sleep apnea syndrome

Objective: In this study, we aimed to search the possible association between Obstructive Sleep Apnea Syndromes (OSAS) severity and thyroid gland malfunctions, and the effects of hypothyroidism on the mode of sleep in patients with OSAS. Methods: Demographic features and thyroid function tests of 211 patients (59, 28% female) with a mean age of 50.9 ± 10.4 years (ranging from 30 to 75) who underwent polysomnography between September 2010 and September 2011 were retrospectively evaluated. Results: Hypothyroidism was detected in 8.3% of the patients with simple snoring and 10.6% of those with OSAS (9.1% in mild OSAS, 20.3% in moderate OSAS and 6.3% in severe OSAS). There was no correlation between the severity of OSAS and the rate of hypothyroidism (p=0.620). The incidence of hypothyroidism was 16.9 % in women and 6.6% in men and this difference was statistically significant (p=0.024). The polysomnographic findings did not differ between the patients with hypothyroidism and the others (table 5). However, in patients with elevated TSH levels, the rate of desaturation during sleep was high despite a lower AHI (r=0.126, p=0.05). Conclusion: No correlation was seen between the severity of OSAS and the rate of hypothyroidism. Women with OSAS had higher incidence of hypothyroidism. The polysomnographic findings did not differ whether the patient had hypothyroidism or not. The rate of desaturation during sleep was relatively high in patients with elevated TSH levels.

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