Increased prevalence of obstructive sleep apnea in patients with Cushing’s syndrome compared with weight- and age-matched controls

Gökosmanoğlu, Feyzi; Güzel, Aygül; Kan, Elif Kilic; Atmaca, Hulusi

doi:10.1530/eje-16-0815

Cited by 24 publications

(19 citation statements)

References 33 publications

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“…Proposed explanations have included elevated growth hormone and insulin‐like growth factor‐I levels that dysregulate the central respiratory drive, and anatomical changes such as increased mandibular and maxillary growth, tongue hypertrophy, and greater oropharyngeal soft‐tissue thickening . The prevalence of OSA is also increased in Cushing's syndrome patients, with hypercortisolemia being an independent risk factor for developing OSA . Obesity, DM, and increased adipose tissue in the subcutaneous tissues of the neck have been attributed to developing OSA in Cushing's syndrome patients …”

Section: Discussionmentioning

confidence: 99%

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Impact of obstructive sleep apnea in transsphenoidal pituitary surgery: An analysis of inpatient data

et al. 2017

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Section: Discussionmentioning

confidence: 99%

“…The prevalence of OSA is also increased in Cushing's syndrome patients, with hypercortisolemia being an independent risk factor for developing OSA . Obesity, DM, and increased adipose tissue in the subcutaneous tissues of the neck have been attributed to developing OSA in Cushing's syndrome patients …”

Section: Discussionmentioning

confidence: 99%

Impact of obstructive sleep apnea in transsphenoidal pituitary surgery: An analysis of inpatient data

et al. 2017

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“…The prevalence of OSA (based on PSG) was higher in women with active CS (n = 35) compared to age-, gender-and BMI-matched controls (n = 30) (50% vs 23%, P = 0.003) (218). After controlling for BMI and HOMA score, serum cortisol remained independently associated with AHI (R 2 : 77.8%, P < 0.001), suggesting that the relationship between CS and OSA are not only related to obesity (218). A recent Taiwanese population-based cohort study showed that patients with CS (n = 53) were at increased risk of developing OSA compared to matched controlled (matched for age, sex and comorbidities including obesity, T2D and hypertension) (4.11 vs 1.70 per thousand person/year; HR 2.82, 95% CI: 1.67-4.77), with slightly higher risk in men vs women (219).…”

Section: Osa In Patients With Cushing's Syndromementioning

confidence: 89%

“…Several studies have shown that OSA is common in patients with Cushing's syndrome (CS) (whether endogenous or exogenous) (217). The prevalence of OSA (based on PSG) was higher in women with active CS (n = 35) compared to age-, gender-and BMI-matched controls (n = 30) (50% vs 23%, P = 0.003) (218). After controlling for BMI and HOMA score, serum cortisol remained independently associated with AHI (R 2 : 77.8%, P < 0.001), suggesting that the relationship between CS and OSA are not only related to obesity (218).…”

Section: Osa In Patients With Cushing's Syndromementioning

confidence: 99%

MECHANISMS OF ENDOCRINOLOGY: Mechanisms of disease: the endocrinology of obstructive sleep apnoea

Lavrentaki

Ali

Cooper

et al. 2019

European Journal of Endocrinology

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Obstructive sleep apnoea (OSA) is a common disorder that is associated with serious comorbidities with a negative impact on quality of life, life expectancy and health costs. As OSA is related to obesity and is associated with sleep disruption, increased inflammation and oxidative stress, it is not surprising that OSA has an impact on the secretion of multiple hormones and is implicated in the development of many endocrine conditions. On the other hand, many endocrine conditions that can affect obesity and/or upper airways anatomy and stability have been implicated in the development or worsening of OSA. This bidirectional relationship between OSA and the endocrine system has been increasingly recognised in experimental and epidemiological studies and there are an increasing number of studies examining the effects of OSA treatment on endocrine conditions and vice versa. In this review article, we will critically appraise and describe the impact of OSA on the endocrine system including obesity, dysglycaemia, the pituitary, the thyroid, the adrenals, the reproductive system and the bones. In each section, we will assess whether a bidirectional relationship exists, and we will describe the potential underlying mechanisms. We have focused more on recent studies and randomised controlled trials where available and attempted to provide the information within clinical context and relevance.

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“…In the first study on obstructive sleep apnoea in patients with active CS, Shipley et al found a prevalence of 32% (seven of 22 subjects), of whom four had clinically significant disorder [61]. More recently, by using overnight polysomnography, Gokosmanoglu et al found the prevalence of obstructive sleep apnoea in a small group of young female patients with newly diagnosed CS to be 50%, compared with 23% in matched controls [64]. In that study, serum cortisol concentrations were independently associated with Apnoea–Hypopnoea Index, after controlling for BMI [64].…”

Section: Neuroimagingmentioning

confidence: 99%

Psychiatric and neurocognitive consequences of endogenous hypercortisolism

et al. 2020

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Psychiatric and neurocognitive symptoms due to hypercortisolism were already described by Harvey Cushing in his original paper on patients with Cushing's syndrome (CS). Nowadays, it is well known that psychiatric and cognitive complaints are two of the most common, and most distressing, symptoms in patients with CS. Psychiatric symptoms are indeed a major clinical manifestation of CS. The most commonly observed psychiatric conditions are depression and anxiety, whilst mania and psychosis are less common. Several domains of cognitive function are impaired at diagnosis, including episodic and working memory, executive function and attention. Following treatment, onefourth of the patients still experience depressed mood, and the cognitive impairments are only partially restored. Consequently, quality of life in patients with CS is severely and persistently affected. Neuroimaging studies have also illustrated the deleterious effects of hypercortisolism on the brain by demonstrating reduced grey matter volumes and cortical thickness, altered restingstate functional responses and during cognitive tasks, as well as widespread reduced white matter integrity, especially in structures important for cognitive function and emotional processing, both before and after successful abrogation of hypercortisolism. In this paper, we summarize the current knowledge on the psychiatric and neurocognitive consequences of hypercortisolism in patients with CS, both before, and after successful treatment. In addition, we review the structural and functional brain abnormalities associated with hypercortisolism and discuss the influence of these factors on quality of life.

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Increased prevalence of obstructive sleep apnea in patients with Cushing’s syndrome compared with weight- and age-matched controls

Abstract: The prevalence of OSA increased in patients with CS compared with control subjects with similar ages and BMI levels. Hypercortisolemia is an independent risk factor for developing OSA. The presence of OSA needs to be considered in patients with CS.

Cited by 24 publications

References 33 publications

Impact of obstructive sleep apnea in transsphenoidal pituitary surgery: An analysis of inpatient data

Impact of obstructive sleep apnea in transsphenoidal pituitary surgery: An analysis of inpatient data

MECHANISMS OF ENDOCRINOLOGY: Mechanisms of disease: the endocrinology of obstructive sleep apnoea

Psychiatric and neurocognitive consequences of endogenous hypercortisolism

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