Hypothyroidism and Obstructive Sleep Apnea
نویسندگان
چکیده
Hypothyroidism is relatively a common disease worldwide. Overall prevalence in adults in the United States is 4.6%. (Golden et al., 2009) It can present as mild/subclinical form or overt hypothyroidism with a prevalence of 4.3% and 0.3% of adult populations, respectively. (Golden et al., 2009) Thyroid hormone deficiency has been linked to increased risk of cardiovascular morbidities and mortalities. (McQuade et al., 2011, Resta et al., 2004) Respiratory system like other body systems and organs is affected by hypothyroidism. The spectrum of diseases involvement can range from mild dyspnea to more severe and lifethreatening respiratory failure. Several pathophysiological mechanisms are responsible for the compromise in the respiratory system including reduction in central respiratory drive, respiratory muscle weakness and sleep-related breathing disorders (SBD). (Duranti et al., 1993, Saaresranta and Polo, 2002, Curnock et al., 1999) Hypothyroidism is characterized by mucopolysaccharides accumulation in the dermis, hypopharynx, tongue and other tissues. (Skatrud et al., 1981, Orr et al., 1981) In its most severe form (myxedema), patients typically present with hypothermia, hypercapnia, hypotension and bradycardia. Both hypothyroidism and obstructive sleep apnea (OSA) share common signs and symptoms. Increased fatigue and sleepiness, decreased cognitive function, decreased libido, obesity and depressed mood are common findings in both disorders. (Grunstein et al., 1993, Misiolek M and 2007, Chan et al., 2010) Periorbital edema and pedal edema are other common findings in patients with either disorder. Nevertheless, snoring which is a hallmark of OSA is also reported in hypothyroid cases. (Misiolek M and 2007, Georgalas, 2011) The overlap between the two disorders may create a problem for the treating physician in differentiating both disorders and may result in a misdiagnosis or under-recognition of one of the disorders. Therefore, it is essential to consider both diseases in high risk patients and initiate the proper therapeutic plan accordingly. This chapter discusses how hypothyroidism interferes with respiratory physiology and then discusses the relationship between hypothyroidism and sleep disordered breathing.
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تاریخ انتشار 2012