Sleep apnea syndrome and hypothyroidism
Open accessAI snapshot
Written from the paper’s full text.
TL;DR
This commentary reviews the relationship between obstructive sleep apnea syndrome (OSAS) and thyroid dysfunction, focusing on a study by Mete et al. that found no difference in hypothyroidism prevalence, thyroid nodules, or parenchymal heterogeneity between OSAS patients and controls. It concludes that much remains unknown and that clinicians should remain aware of the bidirectional association between OSAS and hypothyroidism.
Key findings
- Mete et al. examined 150 polysomnographically diagnosed OSAS patients and 32 controls and found no difference in prevalence of hypothyroidism, numbers of nodules, or parenchyma heterogeneity by ultrasound between OSAS subgroups and controls.
- The prevalence of hypothyroidism in patients suspected of having OSAS does not seem different from the general population, but it is greater in patients with OSAS; Bahammam et al. reported that newly diagnosed clinical hypothyroidism in OSAS patients is low while subclinical hypothyroidism is common.
- In 101 overweight and obese male patients, Meston et al. described a small significant inverse correlation between OSAS and free T4 levels but not TSH; one-month nCPAP treatment significantly reduced TSH without elevating free T4, consistent with recovery from non-thyroidal illness.
- Bratel et al. reported a more pronounced reduction of serum TSH in OSAS patients with the most severe nocturnal hypoxemia, with normal TSH response to TRH before and after nCPAP treatment.
Methods
- Narrative commentary/review discussing the study by Mete et al. and other cited literature on OSAS and thyroid disease.
- Data discussed include Mete et al.’s 150 OSAS patients and 32 controls, Meston et al.’s 101 overweight/obese male patients, and the author’s own prior study in obese patients with OSAS.
- Main analysis is a narrative synthesis of cited studies; no new primary data or systematic search is reported.
Limitations
- The paper states that the incidence of thyroid deficiency states in patients with OSAS is not clearly known, that much remains to be learned about diagnosis and treatment, and that further investigations are needed.
- The paper states that the selection of patients who should undergo more specific evaluations is an open issue.
- Evident from the text: this is a single-author commentary/editorial rather than a systematic review or meta-analysis, and it relies on selected cited studies without a described systematic search strategy.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
8 of 18 cited sources checked · 6 supported · 0 flagged · accuracy not yet measured
- Premisecitation§ Sleep apnea syndrome and hypothyroidism
Obese patients with OSAS show alterations in GH/IGF-I axis function, PRL secretion, HPA axis and gonadal axis activity.
“Obese patients with OSAS show alterations in the GH/IGF-I axis function, PRL secretion, HPA axis and gonadal axis activity.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [6] F. Lanfranco, G. Motta, M.A. Minetto, M. Baldi, M. Balbo, E. Ghigo, E. Arvat, M. Maccario, Neuroendocrine alterations in obese patients with sleep apnea syndrome. Int. J. Endocrinol. 2010, 474518 (2010) source
Sections 3.1, 3.3 and 3.5 describe altered GH/IGF-I, HPA-axis and gonadal-axis activity in obese patients with OSAS. Section 3.2 says findings on PRL secretion conflict: some studies report altered PRL pulse frequency, while the authors found similar PRL measures in obese patients with and without OSAS. The unqualified claim of altered PRL secretion is therefore stronger than the review supports. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Premisecitation§ Sleep apnea syndrome and hypothyroidism
Some derangement in TSH secretion in obesity with or without OSAS has been demonstrated.
“In fact, some derangement in TSH secretion in obesity with or without OSAS has been demonstrated [2,4].”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites [2] T. Bratel, A. Wennlund, K. Carlstrom, Pituitary reactivity, androgens and catecholamines in obstructive sleep apnea. Effects of continuous positive airway pressure treatment (CPAP). Respir. Med. 93, 1–7 (1999) source
The Discussion (page not available in our copy) reports lower basal TSH in patients with OSAS than in controls, supporting a TSH disturbance in OSAS. It does not establish a TSH secretion disturbance in obesity without OSAS, or attribute the finding to obesity itself. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [4] R. Grunstein, J. Handelsman, S.J. Lawrence, C. Blackwell, J. Caterson, C.E. Sullivan, Neuroendocrine dysfunction in sleep apnea: reversal by continuous positive airways pressure therapy. J. Clin. Endocrinol. Metab. 68, 352–358 (1989) source
- Premisecitation§ Sleep apnea syndrome and hypothyroidism
Mete et al. did not find any difference in prevalence of hypothyroidism (including subclinical and overt) between OSAS patients and controls.
“The authors did not find any difference in prevalence of hypothyroidism, numbers of nodules, and parenchyma heterogenecity determined by ultrasound, between OSAS subgroups and controls.”
- Also stated in: § Sleep apnea syndrome and hypothyroidism · plain
“Mete et al. [9] did not find a significant difference in the prevalence of subclinical and overt hypothyroidism in OSAS patients and controls.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] T. Mete, Y. Yalcin, D Berker, B. Ciftci, S. Guven Firat, O. Topaloglu, H. Cinar Yavuz, S. Guler, Relationship between obstructive sleep apnea syndrome and thyroid diseases. Endocrine (2013) [Epub ahead of print] source
- Also stated in: § Sleep apnea syndrome and hypothyroidism · plain
- Interpretationreasoning§ Sleep apnea syndrome and hypothyroidism
The Mete study did not reveal any relationship between OSAS and thyroid disease.
“Thus this study did not reveal any relationship between OSAS and thyroid disease.”
Quote in the paperSubstantial claim - Premisecitation§ Sleep apnea syndrome and hypothyroidism
Mete et al. did not find any difference in parenchyma heterogeneity between OSAS subgroups and controls.
“The authors did not find any difference in prevalence of hypothyroidism, numbers of nodules, and parenchyma heterogenecity determined by ultrasound, between OSAS subgroups and controls.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] T. Mete, Y. Yalcin, D Berker, B. Ciftci, S. Guven Firat, O. Topaloglu, H. Cinar Yavuz, S. Guler, Relationship between obstructive sleep apnea syndrome and thyroid diseases. Endocrine (2013) [Epub ahead of print] source
- Premisecitation§ Sleep apnea syndrome and hypothyroidism
The increased prevalence of OSAS appears to be related to obesity and male sex rather than to hypothyroidism per se.
“The increased prevalence of OSAS appears to be related to obesity and male sex rather than to hypothyroidism per se, although decreased ventilatory responses, extravasation of albumin, and mucopolysaccharides in the tissues of the upper airway and hypothyroid myopathy have been suggested as possible contributing factors for OSAS in hypothyroidism [3].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [3] R.R. Grunstein, C.E. Sullivan, Sleep apnea and hypothyroidism: mechanisms and management. Am. J. Med. 85, 775–779 (1988) source
- Interpretationreasoning§ Sleep apnea syndrome and hypothyroidism
Hypothyroidism may cause OSAS.
“Endocrinologists and professionals dealing with sleep disturbances and OSAS should bear in mind that hypothyroidism may cause OSAS and that OSAS may be linked to (or even cause) hypothyroidism.”
Quote in the paperSubstantial claim - Premisecitation§ Sleep apnea syndrome and hypothyroidism
A link between hypothyroidism and OSAS is suggested by the high prevalence of sleep apnea among hypothyroid patients, particularly in rare myxedematous cases.
“A link between hypothyroidism and OSAS is suggested by the high prevalence of sleep apnea among hypothyroid patients, particularly in rare myxedematous cases [3,7].”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation§ Sleep apnea syndrome and hypothyroidism
Mete et al. did not find any difference in numbers of nodules between OSAS subgroups and controls.
“The authors did not find any difference in prevalence of hypothyroidism, numbers of nodules, and parenchyma heterogenecity determined by ultrasound, between OSAS subgroups and controls.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] T. Mete, Y. Yalcin, D Berker, B. Ciftci, S. Guven Firat, O. Topaloglu, H. Cinar Yavuz, S. Guler, Relationship between obstructive sleep apnea syndrome and thyroid diseases. Endocrine (2013) [Epub ahead of print] source
- Interpretationreasoning§ Sleep apnea syndrome and hypothyroidism
Missing the diagnosis of hypothyroidism in OSAS patients may lead to inappropriate or unnecessary nCPAP treatment.
“Missing the diagnosis of hypothyroidism in OSAS patients may lead to inappropriate or unnecessary nCPAP treatment.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 2
- May combine two claims. 10
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Sleep apnea syndrome and hypothyroidismSome derangement in TSH secretion in obesity with or without OSAS has been demonstrated by some authors, whereas normal thyroid activity has been described by others.
“Some derangement in TSH secretion in obesity with or without OSAS has been demonstrated by some authors, whereas a normal thyroid activity has been described by others [5,6].”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites [5] F. Lanfranco, L. Gianotti, S. Pivetti, F. Navone, R. Rossetto, F. Tassone, V. Gai, E. Ghigo, M. Maccario, Obese patients with obstructive sleep apnoea syndrome show a peculiar alteration of the corticotroph but not of the thyrotroph and lactotroph function. Clin. Endocrinol. 60, 41–48 (2004) source
- cites [6] F. Lanfranco, G. Motta, M.A. Minetto, M. Baldi, M. Balbo, E. Ghigo, E. Arvat, M. Maccario, Neuroendocrine alterations in obese patients with sleep apnea syndrome. Int. J. Endocrinol. 2010, 474518 (2010) source
May combine two claims.
Premisecitation§ Sleep apnea syndrome and hypothyroidismOSAS is strongly associated with obesity and is characterized by endocrine and metabolic abnormalities that are frequently more marked than those in obese patients without OSAS, suggesting that factors other than obesity per se have a role in this clinical condition.
“It is strongly associated with obesity and is characterized by several endocrine and metabolic abnormalities that are frequently more marked than those in obese patients without OSAS, suggesting that factors other than obesity per se have a role in this clinical condition [6].”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [6] F. Lanfranco, G. Motta, M.A. Minetto, M. Baldi, M. Balbo, E. Ghigo, E. Arvat, M. Maccario, Neuroendocrine alterations in obese patients with sleep apnea syndrome. Int. J. Endocrinol. 2010, 474518 (2010) source
May combine two claims.
Premisecitation§ Sleep apnea syndrome and hypothyroidismOne-month nCPAP treatment compared to placebo resulted in a significant reduction in TSH without elevation in free T4 levels, consistent with the pattern of recovery from non-thyroidal illness.
“One-month nCPAP treatment compared to placebo resulted in a significant reduction in TSH without elevation in free T4 levels, consistent with the pattern of recovery from non-thyroidal illness.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [8] N. Meston, R.J.O. Davies, R. Mullins, C. Jenkinson, J.A.H. Wass, J.R. Stradling, Endocrine effects of nasal continuous positive airway pressure in male patients with obstructive sleep apnoea. J. Intern. Med. 254, 447–454 (2003) source
May combine two claims.
Premisecitation§ Sleep apnea syndrome and hypothyroidismMeston et al. described a small significant inverse correlation between OSAS and free T4 levels but not TSH, with no apparent association between obesity and either hormone.
“In 101 overweight and obese male patients, Meston et al. [8] have described a small significant inverse correlation between OSAS and free T4 levels but not TSH, with no apparent association between obesity and either hormone.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [8] N. Meston, R.J.O. Davies, R. Mullins, C. Jenkinson, J.A.H. Wass, J.R. Stradling, Endocrine effects of nasal continuous positive airway pressure in male patients with obstructive sleep apnoea. J. Intern. Med. 254, 447–454 (2003) source
May combine two claims.
Premisecitation§ Sleep apnea syndrome and hypothyroidismBratel et al. reported a more pronounced reduction of serum TSH in OSAS patients with the most severe nocturnal hypoxemia, with a normal TSH response to TRH before and after nCPAP treatment.
“Bratel et al. [2] have reported a more pronounced reduction of serum TSH in OSAS patients with the most severe nocturnal hypoxemia, with a normal TSH response to TRH before and after nCPAP treatment.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [2] T. Bratel, A. Wennlund, K. Carlstrom, Pituitary reactivity, androgens and catecholamines in obstructive sleep apnea. Effects of continuous positive airway pressure treatment (CPAP). Respir. Med. 93, 1–7 (1999) source
May combine two claims.
Premisecitation§ Sleep apnea syndrome and hypothyroidismBahammam et al. showed that the prevalence of newly diagnosed clinical hypothyroidism in OSAS patients is low while subclinical hypothyroidism is common.
“Interestingly, Bahammam et al. [1] showed that the prevalence of newly diagnosed clinical hypothyroidism in OSAS patients is low while subclinical hypothyroidism is common.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [1] S.A. Bahammam, M.M. Sharif, A.A. Jammah, A.S. Bahammam, Prevalence of thyroid disease in patients with obstructive sleep apnea. Respir. Med. 105, 1755–1760 (2011) source
May combine two claims.
Interpretationreasoning§ Sleep apnea syndrome and hypothyroidismOSAS may be linked to or even cause hypothyroidism.
“Endocrinologists and professionals dealing with sleep disturbances and OSAS should bear in mind that hypothyroidism may cause OSAS and that OSAS may be linked to (or even cause) hypothyroidism.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ Sleep apnea syndrome and hypothyroidismnCPAP treatment can be necessary initially and in some patients even after remission of clinical signs of hypothyroidism.
“Nocturnal Continuous Positive Airway Pressure (nCPAP) treatment can be necessary initially and in some patients even after remission of clinical signs of hypothyroidism [11].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [11] F. Rosenow, V. McCarthy, A.C. Caruso, Sleep apnoea in endocrine diseases. J. Sleep Res. 7, 3–11 (1998) source
May combine two claims.
Premisecitation§ Sleep apnea syndrome and hypothyroidismIn a group of obese patients with OSAS, no impaired thyroid activity in basal conditions nor altered TSH response to TRH challenge test was found.
“Concerning the role of OSAS in inducing thyroid dysfunction, in a group of obese patients with OSAS I have not found an impaired thyroid activity in basal conditions nor an altered TSH response to TRH challenge test [5], in agreement with some but not other studies.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [5] F. Lanfranco, L. Gianotti, S. Pivetti, F. Navone, R. Rossetto, F. Tassone, V. Gai, E. Ghigo, M. Maccario, Obese patients with obstructive sleep apnoea syndrome show a peculiar alteration of the corticotroph but not of the thyrotroph and lactotroph function. Clin. Endocrinol. 60, 41–48 (2004) source
Classified as probably not a substantial claim.
Interpretationreasoning§ Sleep apnea syndrome and hypothyroidismMissing the diagnosis of OSAS in hypothyroid patients may lead to an increased morbidity and mortality due to the well-known increased cardio-vascular risk of this syndrome.
“However, clinicians should be aware that missing the diagnosis of OSAS (in hypothyroid patients) may lead to an increased morbidity and mortality due to the well-known increased cardio-vascular risk of this syndrome.”
Quote in the paperSubstantial claim- Rests on an assumption: OSAS is associated with an increased cardiovascular risk.
May combine two claims.
Interpretationcitation§ Sleep apnea syndrome and hypothyroidismOverall the prevalence of hypothyroidism in patients suspected of having OSAS does not seem to be different from the one in the general population, but it is greater in patients with OSAS.
“Overall the prevalence of hypothyroidism in patients suspected of having OSAS does not seem to be different from the one in the general population, but it is greater in patients with OSAS.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Large goiters alone can cause pharynx occlusion and thus OSAS, regardless of hypothyroidism.
“In fact, regardless of hypothyroidism, large goiters alone can cause pharynx occlusion and thus OSAS.”
The paper relies on this without support.
The incidence of thyroid deficiency states in patients with OSAS is not clearly known.
“As a matter of fact, the incidence of thyroid deficiency states in patients with OSAS is not clearly known, thus the opportunity to evaluate thyroid function in all patients with the syndrome is still debated.”
The paper relies on this without support.
OSAS and hypothyroidism have several common signs that create a significant risk of undiagnosed hypothyroidism in OSAS.
“It is well known that OSAS and hypothyroidism have several common signs that create a significant risk of undiagnosed hypothyroidism in OSAS.”
The paper relies on this without support.
Contrasting data are available concerning the efficacy of thyroid replacement therapy in improving sleep apnea in patients with clinical hypothyroidism.
“Moreover, contrasting data are available concerning the efficacy of thyroid replacement therapy in improving sleep apnea in patients with clinical hypothyroidism.”
The paper relies on this without support.
OSAS is associated with an increased cardiovascular risk.
“due to the well-known increased cardio-vascular risk of this syndrome”
Cites
Neuroendocrine Dysfunction in Sleep Apnea: Reversal by Continuous Positive Airways Pressure Therapy*
GRUNSTEIN, R. R., HANDELSMAN, D. J., LAWRENCE, S. J., BLACKWELL, C., CATERSON, I. D., & SULLIVAN, C. E. (1989) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-68-2-352 · Cited by 302 · see citing works
Bratel, T., Wennlund, A., & Carlström, K. (1999) · Respiratory Medicine · doi:10.1016/s0954-6111(99)90068-9 · Cited by 168 · see citing works
The Relationship between Sleep Apnea Syndrome and Hypothyroidism
Lin, C.-C., Tsan, K.-W., & Chen, P.-J. (1992) · Chest · doi:10.1378/chest.102.6.1663 · Cited by 167 · see citing works
Meston, N., Davies, R. J. O., Mullins, R., Jenkinson, C., Wass, J. A. H., & Stradling, J. R. (2003) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2003.01212.x · Cited by 163 · see citing works
Sleep apnea and hypothyroidism: mechanisms and management
Grunstein, R. R., & Sullivan, C. E. (1988) · The American Journal of Medicine · doi:10.1016/s0002-9343(88)80020-2 · Cited by 158 · see citing works
Sleep apnoea in endocrine diseases
ROSENOW, F., McCARTHY, V., & CARUSO, A. (1998) · Journal of Sleep Research · doi:10.1046/j.1365-2869.1998.00086.x · Cited by 96 · see citing works
Screening for Hypothyroidism in Sleep Apnea
SKJODT, N. M., ATKAR, R., & EASTON, P. A. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.160.2.9802051 · Cited by 92 · see citing works
Prevalence of thyroid disease in patients with obstructive sleep apnea
Bahammam, S. A., Sharif, M. M., Jammah, A. A., & BaHammam, A. S. (2011) · Respiratory Medicine · doi:10.1016/j.rmed.2011.07.007 · Cited by 90 · see citing works
Neuroendocrine alterations in obese patients with sleep apnea syndrome
Lanfranco, F., Motta, G., Minetto, M. A., Baldi, M., Balbo, M., Ghigo, E., Arvat, E., & Maccario, M. (2010) · International Journal of Endocrinology · doi:10.1155/2010/474518 · Cited by 78 · see citing works
Lanfranco, F., Gianotti, L., Pivetti, S., Navone, F., Rossetto, R., Tassone, F., Gai, V., Ghigo, E., & Maccario, M. (2004) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2004.01938.x · Cited by 58 · see citing works
Self-citationRelationship between obstructive sleep apnea syndrome and thyroid diseases
Mete, T., Yalcin, Y., Berker, D., Ciftci, B., Guven Firat, S., Topaloglu, O., Cinar Yavuz, H., & Guler, S. (2013) · Endocrine · doi:10.1007/s12020-013-9927-9 · Cited by 46 · see citing works
Thyroid Testing and Thyroid Hormone Replacement in Patients with Sleep Disordered Breathing
Mickelson, S. A., Lian, T. F., & Rosenthal, L. D. (1999) · Ear Nose & Throat Journal · doi:10.1177/014556139907801009 · Cited by 37 · see citing works
Prevalence of thyroid disease in patients with obstructive sleep apnea
BaHammam, A. S., Sharif, M. M., Jammah, A. A., & Bahammam, S. A. (2011) · European Respiratory Journal · doi:10.1183/13993003/erj.38.suppl_55.p3463
Flagged first, then by citations
Cited by
Sorted by citations
Role of hypothyroidism in obstructive sleep apnea: a meta-analysis
Zhang, M., Zhang, W., Tan, J., Zhao, M., Zhang, Q., & Lei, P. (2016) · Current Medical Research and Opinion · doi:10.1185/03007995.2016.1157461 · Cited by 53 · see citing works
Sleep apnea syndrome in endocrine clinics
Ceccato, F., Bernkopf, E., & Scaroni, C. (2015) · Journal of Endocrinological Investigation · doi:10.1007/s40618-015-0338-z · Cited by 36 · see citing works
“While contrasting data are available on the efficacy of thyroid replacement therapy in improving OSAS symptoms in hypothyroid patients [23, 26], Bratel et al.”
BackgroundInfluentialFeng, H., Jiang, T., Zhang, H.-P., Wang, Z., Zhang, H., Zhang, H., Chen, X., Fan, X.-L., Tian, Y.-D., & Jia, T. (2015) · BioMed Research International · doi:10.1155/2015/523716 · Cited by 22 · see citing works
Valadares, R. J. B., Sousa, K. G., Espindola, M., Gaio, E., & Viegas, C. A. D. A. (2015) · World Journal of Neuroscience · doi:10.4236/wjns.2015.51006 · Cited by 6 · see citing works
Hormone Imbalance a Cause for Concern in Women
Roop, J. (2018) · Research Journal of Life Sciences Bioinformatics Pharmaceutical and Chemical Sciences · doi:10.26479/2018.0402.18 · Cited by 4 · see citing works
Lu, N., Chen, B., Liu, P., Wang, C., Lu, Z., & Li, S. (2024) · Medicine · doi:10.1097/md.0000000000040114 · Cited by 2 · see citing works
Neurological manifestations in the case of impaired function of thyroid and parathyroid glands
Kopchak, O. O., Odintsova, T. A., & Bachynska, N. Y. (2018) · Ukrainian Neurological Journal · doi:10.30978/unz2018218
Galeano, S. A., Lopera, J. F. G., Corredor-Zuluaga, D. A., & Navarro, A. C. N. (2017) · ACTA DE OTORRINOLARINGOLOGÍA & CIRUGÍA DE CABEZA Y CUELLO · doi:10.37076/acorl.v43i2.18
- Authors
- Lanfranco, F.
- Affiliations
- University of Turin (IT)
- Corresponding author
- Lanfranco, Fabio
- ORCID
- Lanfranco, Fabio
- Venue
- Endocrine
- Published
- 2013-10-12
- Volume
- 44
- Issue
- 3
- Pages
- 551-552
- ISSN
- 0969-711X (ISSN-L)
- 1355-008X
- 1559-0100
- OpenAlex
- W2009032106
- Semantic Scholar
- 0699ca5228e459ed00bdc0990f8e2923f1500031
- Cited by
- 8
- References
- 12
- Citations by year
- 2024: 1 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 3
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Endocrine (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- sleep apnea, hypothyroidism, obstructive sleep apnea, thyroid dysfunction
- MeSH terms
- Female, Humans, Male, Thyroid Diseases, Sleep Apnea, Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-23.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-23.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
