Füsun SAYGILI, Ilgın YILDIRIM ŞİMŞİR, Mehmet Sezai TAŞBAKAN, Özen KAÇMAZ BAŞOĞLU

Obstructive sleep apnea characteristics in patients with well-controlled acromegaly and their compliance with positive airway pressure therapy

Background/aim: Acromegaly is often associated with obstructive sleep apnea syndrome (OSAS) with a frequency between 40% and 80%. The aim of the present study was to evaluate the clinical and polysomnographic characteristics of acromegaly patients with sleep apnea symptoms and to identify positive airway pressure (PAP) adherence in acromegaly patients with OSAS diagnosis. Materials and methods: Twenty-eight well-controlled acromegaly patients (17 males, mean age 48.7 ± 10.1 years) with sleep apnea symptoms were included in this prospective study. Demographic data, anthropometric measurements, and medical history were evaluated. Full-night in-laboratory polysomnography was performed. Results: Polysomnography results showed that 25 patients (89.3%) had OSAS with a mean apnea-hypopnea index (AHI) of 37.7 ± 28.8/h. All 17 male patients were diagnosed with OSAS, whereas 8 female patients (72.7%) had OSAS (P = 0.05). Male patients also had more severe OSAS than females (AHI 48.3 ± 29.0 vs. 21.3 ± 20.1 events/h, respectively; P = 0.012). Twenty-two patients out of 28 were considered to be eligible candidates for PAP therapy. The PAP adherence rate was found to be 50% during follow-up. Conclusion: Our results confirm OSAS as a common disorder in acromegaly patients as well as PAP therapy being required for a majority of patients. Therefore, all acromegaly patients should be assessed in terms of OSAS and be followed closely for the evaluation of PAP adherence.

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1. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013; 177: 1006-1014.
2. Ben-Sholmo A, Melmed S. Acromegaly. Endocrinol Metab Clin North Am 2008; 37: 101-122.
3. Alexander L, Appleton D, Hall R, Ross WM, Wilkinson R. Epidemiology of acromegaly in the Newcastle region. Clin Endocrinol 1980; 12: 71-79.
4. Bengtsson BA, Eden S, Ernst I, Oden A, Sjogren B. Epidemiology and long-term survival in acromegaly. Acta Med Scand 1988; 223: 327-335.
5. Hernández-Gordillo D, del Rocio Ortega-Gómez M, GaliciaPolo L, Castorena-Maldonado A, Vergara-López A, A, GuillénGonzález MÁ, Torre-Bouscoulet L. Sleep apnea in patients with acromegaly. Frequency, characterization and positive pressure titration. Open Respir Med J 2012; 6: 28-33.
6. Blanco Pérez JJ, Blanco-Ramos MA, Zamarrón Sanz C, Souto Fernández A, Mato Mato A, Lamela López J. Acromegaly and sleep apnea. Arch Bronconeumol 2004; 40: 355-359.
7. Roemmler J, Gutt B, Fischer R, Vay S, Wiesmeth A, Bidlingmaier M, Schopohl J, Angstwurm M. Elevated incidence of sleep apnoea in acromegaly-correlation to disease activity. Sleep Breath 2012; 16: 1247-1253.
8. Izci B, Ardic S, Firat H, Sahin A, Altinors M, Karacan I. Reliability and validity studies of the Turkish version of the Epworth sleepiness scale. Sleep Breath 2008; 12: 161-168.
9. Iber C, Ancoli-Israel S, Chesson AL, Quan SF. The AASM Manual 2007 for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. Westchester, IL, USA: American Academy of Sleep Medicine; 2007.
10. American Academy of Sleep Medicine. International Classification of Sleep Disorders. Diagnostic and Coding Manual (ICSD-2). 2nd ed. Westchester, IL, USA: American Academy of Sleep Medicine; 2005.
11. Kribbs NB, Pack AI, Kline LR, Smith PL, Schwartz AR, Schubert NM, Redline S, Henry JN, Getsy JE, Dinges DF. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 1993; 147: 887-895.
12. Vannucci L, Luciani P, Gagliardi E, Paiano S, Duranti R, Forti G, Peri Al. Assessment of sleep apnea syndrome in treated acromegalic patients and correlation of its severity with clinical and laboratory parameters. J Endocrinol Invest 2013; 36: 237- 242.
13. Davi MV, Dalle Carbonare L, Giustina A, Ferrari M, Frigo A, Lo Cascio V, Francia G. Sleep apnoea syndrome is highly prevalent in acromegaly and only partially reversible after biochemical control of the disease. Eur J Endocrinol 2008; 159: 533-540.
14. Van Haute FR, Taboada GF, Corrêa LL, Lima GA, Fontes R, Riello AP, Dominici M, Gadelha MR. Prevalence of sleep apnea and metabolic abnormalities in patients with acromegaly and analysis of cephalometric parameters by magnetic resonance imaging. Eur J Endocrinol 2008; 158: 459-465.
15. Kashine S, Kishida K, Funahashi T, Shimomura I. Characteristics of sleep-disordered breathing in Japanese patients with acromegaly. Endocr J 2012; 59: 31-38.
16. Annamalai AK, Webb A, Kandasamy N, Elkhawad M, Moir S, Khan F, Maki-Petaja K, Gayton EL, Strey CH, OToole S et al. A comprehensive study of clinical, biochemical, radiological, vascular, cardiac, and sleep parameters in an unselected cohort of patients with acromegaly undergoing presurgical somatostatin receptor ligand therapy. J Clin Endocrinol Metab 2013; 98: 1040-1050.
17. Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc 2008; 5: 173-178.
18. Arısoy A, Taşbakan MS, Başoğlu OK. The factors affecting positive airway pressure therapy compliance in patients with obstructive sleep apnea syndrome. In: Turkish Thoracic Society 19th Annual Congress, 610 April 2016, Antalya, Turkey, pp. 199-200 (in Turkish).