Endocrine disorders in obstructive sleep apnoea syndrome: A bidirectional relationship

Abstract

Obstructive sleep apnoea (OSA) is a common disorder characterized by recurrent episodes of apnoea or hypopnea due to total or partial pharyngeal collapse and temporary upper airway obstruction during sleep. The prevalence of OSA is increasing and currently affects about 30% of men and 13% of women in Europe.Intermittent hypoxia, oxidative stress, systemic inflammation, and sleep fragmentation resulting from OSA can provoke subsequent cardiometabolic disorders. The relationships between endocrine disorders and OSA are complex and bidirectional. Indeed, several endocrine disorders are risk factors for OSA. Compared with the general population, the prevalence of OSA is increased in patients with obesity, hypothyroidism, acromegaly, Cushing syndrome, and type 1 and 2 diabetes. In some cases, treatment of the underlying endocrine disorder can improve, and occasionally cure, OSA. On the other hand, OSA can also induce endocrine disorders, particularly glucose metabolism abnormalities. Whether continuous positive airway pressure (CPAP) treatment for OSA can improve these endocrine disturbances remains unclear due to the presence of several confounding factors. In this review, we discuss the current state-of-the-art based on the review of the current medical literature for key articles focusing on the bidirectional relationship between endocrine disorders and OSA and the effects of treatment. Screening of OSA in endocrine patients is also discussed, as it remains a subject of debate.

Factors Associated with Persistent Obstructive Sleep Apnea After Bariatric Surgery: A Narrative Review

“…de Raaff et al 27 concluded that severe apnea (AHI ≥ 30) before surgery was a predictive factor of OSA persistence. Yanari et al 4 also observed that pre-operative AHI was an independent prognostic factor of OSA persistence. In Ravesloot et al, 29 age was not a predictive factor of OSA remission, unlike the results from de Raaff et al 27 in which older age predicted OSA persistence.…”

“…A meta-analysis of studies that followed patients up to 24 months indicated that the remission rate of T2D was 63.5%–82%. 46 Since T2D is a risk factor for OSA, 4 persistence of T2D could be an explanation for OSA persistence after bariatric surgery.…”

Causal associations between obstructive sleep apnea and COVID-19: A bidirectional Mendelian randomization study

“…Obstructive sleep apnea (OSA) is a prevalent and under-diagnosed disorder characterized by repeated closure of the upper airway tract during sleep, resulting in sleep fragmentation and intermittent hypoxia [ 4 ]. This disorder not only causes daytime drowsiness, but also exacerbates cardiovascular issues, obesity-related metabolic dysfunction, systemic inflammation, and a weakened immunological response to infection [ 5 , 6 ]. Whether OSA is a risk factor for COVID-19, particularly severe COVID-19, has long been a subject of debate.…”

Development and assessment of a risk prediction model for moderate-to-severe obstructive sleep apnea

“…In addition, it is worth noting that patients with moderate-to-severe OSA have a higher incidence of asymptomatic cerebrovascular disease than those with less severe OSA (Nishibayashi et al, 2008). OSA is also affecting the metabolism of endocrine hormone levels, and patients with OSA are at a higher risk of developing certain endocrine and metabolic diseases (Akset et al, 2022). The relationship between endocrine disorders and OSA is complex and bidirectional.…”