Risk of obstructive sleep apnea among patients with Cushing's syndrome: a nationwide longitudinal study

Wang, Ling Uei; Wang, Tsung-Yang; Bai, Ya Mei; Hsu, Ju Wei; Huang, Kou‐Yuan; Su, Tung Ping; Li, Cheng Ta; Lin, Wei Chen; Chen, Tzeng Ji; Chen, Mu Hong

doi:10.1016/j.sleep.2017.04.016

Cited by 18 publications

(15 citation statements)

References 20 publications

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“…In that study, serum cortisol concentrations were independently associated with Apnoea–Hypopnoea Index, after controlling for BMI [64]. Finally, a threefold increased risk for obstructive sleep apnoea was noted in a large cohort of patients with CS [65]. However, in that study, neither the diagnosis nor the aetiology of the syndrome was validated, and information on remission status was missing.…”

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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Section: Neuroimagingmentioning

confidence: 99%

Psychiatric and neurocognitive consequences of endogenous hypercortisolism

et al. 2020

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“…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). Interestingly in this study, the survival curves for OSA development starting separating clearly from the first year after the diagnosis of CS (219).…”

Section: Osa In Patients With Cushing's Syndromementioning

confidence: 99%

“…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). Interestingly in this study, the survival curves for OSA development starting separating clearly from the first year after the diagnosis of CS (219). Similarly, in patients without OSA (n = 17) who had PSG before and after 3 months of prednisolone (10 mg daily or more), AHI worsened by 56% compared to controls (with mild OSA but no steroid treatment) (220).…”

Section: Osa In Patients With Cushing's Syndromementioning

confidence: 99%

“…Moreover, hypercortisolism can induce UA myopathy leading to compromised UAs ( Fig. 6) (217,219,222).…”

Section: Osa In Patients With Cushing's Syndromementioning

confidence: 99%

“…The weakness of UA muscles (sternohyoid muscle) also contributes to the increased risk of UA collapsibility in patients with acromegaly (235). Other factors include hypothyroidism, large goitres (detailed later) (219,236,237), IR and dysglycaemia (219,224,238).…”

Section: Osa and The Dysregulation Of Gh/igf Axismentioning

confidence: 99%

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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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Anesthesia for Pituitary Lesions

Cafiero¹

2019

Textbook of Neuroanesthesia and Neurocritical Care

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Risk of obstructive sleep apnea among patients with Cushing's syndrome: a nationwide longitudinal study

Cited by 18 publications

References 20 publications

Psychiatric and neurocognitive consequences of endogenous hypercortisolism

Psychiatric and neurocognitive consequences of endogenous hypercortisolism

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

Anesthesia for Pituitary Lesions

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