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Open Access 01-11-2018 | Original Article

Temporal relationship of sleep apnea and acromegaly: a nationwide study

Authors: Konstantina Vouzouneraki, Karl A. Franklin, Maria Forsgren, Maria Wärn, Jenny Tiberg Persson, Helena Wik, Christina Dahlgren, Ann-Sofie Nilsson, Caroline Alkebro, Pia Burman, Eva-Marie Erfurth, Jeanette Wahlberg, Anna-Karin Åkerman, Charlotte Høybye, Oskar Ragnarsson, Britt Edén Engström, Per Dahlqvist

Published in: Endocrine | Issue 2/2018

Abstract

Purpose

Patients with acromegaly have an increased risk of sleep apnea, but reported prevalence rates vary largely. Here we aimed to evaluate the sleep apnea prevalence in a large national cohort of patients with acromegaly, to examine possible risk factors, and to assess the proportion of patients diagnosed with sleep apnea prior to acromegaly diagnosis.

Methods

Cross-sectional multicenter study of 259 Swedish patients with acromegaly. At patients’ follow-up visits at the endocrine outpatient clinics of all seven university hospitals in Sweden, questionnaires were completed to assess previous sleep apnea diagnosis and treatment, cardiovascular diseases, smoking habits, anthropometric data, and S-IGF-1 levels. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale. Patients suspected to have undiagnosed sleep apnea were referred for sleep apnea investigations.

Results

Of the 259 participants, 75 (29%) were diagnosed with sleep apnea before the study start. In 43 (57%) of these patients, sleep apnea had been diagnosed before the diagnosis of acromegaly. After clinical assessment and sleep studies, sleep apnea was diagnosed in an additional 20 patients, yielding a total sleep apnea prevalence of 37%. Higher sleep apnea risk was associated with higher BMI, waist circumference, and index finger circumference. Sleep apnea was more frequent among patients with S-IGF-1 levels in the highest quartile.

Conclusion

Sleep apnea is common among patients with acromegaly, and is often diagnosed prior to their acromegaly diagnosis. These results support early screening for sleep apnea in patients with acromegaly and awareness for acromegaly in patients with sleep apnea.

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Title: Temporal relationship of sleep apnea and acromegaly: a nationwide study
Authors: Konstantina Vouzouneraki
Karl A. Franklin
Maria Forsgren
Maria Wärn
Jenny Tiberg Persson
Helena Wik
Christina Dahlgren
Ann-Sofie Nilsson
Caroline Alkebro
Pia Burman
Eva-Marie Erfurth
Jeanette Wahlberg
Anna-Karin Åkerman
Charlotte Høybye
Oskar Ragnarsson
Britt Edén Engström
Per Dahlqvist
Publication date: 01-11-2018
Publisher: Springer US
Published in: Endocrine / Issue 2/2018
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-018-1694-1

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