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Cited by 92Obstructive Sleep Apnea ResearchThyroid Disorders and TreatmentsSleep and related disorders

Screening for Hypothyroidism in Sleep Apnea

SKJODT, NEIL M., ATKAR, RAJ, EASTON, PAUL A.·1999·American Journal of Respiratory and Critical Care Medicine
DOI 10.1164/ajrccm.160.2.9802051
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Abstract

Primary sleep apnea–hypopnea syndrome (obstructive sleep apnea [OSA]) and hypothyroidism have many signs and symptoms in common. The overlap in clinical presentation, and the sleep-disordered breathing that can accompany hypothyroidism, create a significant risk of misdiagnosis of sleep apnea among patients referred to sleep clinic who have undiagnosed hypothyroidism. We determined the point prevalence of hypothyroidism in our sleep clinic patients with newly diagnosed sleep-disordered breathing. Of 290 sequential patients referred to sleep clinic, 200 (69%) patients judged at high risk for OSA underwent polysomnography (PSG) and biochemical screening for hypothyroidism. Of these, 124 (62%) were judged to have sleep apnea. This included three patients (1.5% of patients undergoing PSG or 2.4% of those judged to have OSA) who were also discovered to have previously undiagnosed hypothyroidism. These three patients with “secondary” sleep apnea were treated with thyroxine therapy alone, and followed with sequential sleep studies and serum thyroid hormone assays; symptoms, sleep-disordered breathing, nocturnal hypoxia, and thyroid deficiency resolved simultaneously. We conclude that biochemical screening for hypothyroidism is required to prevent inadvertent misdiagnosis of hypothyroid sleep-disordered breathing as primary sleep apnea, and that it is a cost-effective component of the investigation of sleep apnea.

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Crossref · 10.1164/ajrccm.160.2.9802051

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Authors
SKJODT, N. M., ATKAR, R., & EASTON, P. A.
Affiliations
University of Calgary (CA)
ORCID
EASTON, PAUL A.
Venue
American Journal of Respiratory and Critical Care Medicine
Publisher
Oxford University Press (OUP)
Published
1999-08-01
Volume
160
Issue
2
Pages
732-735
ISSN
  • 1073-449X (ISSN-L)
  • 1535-4970
DOI
10.1164/ajrccm.160.2.9802051
OpenAlex
W2163242578
Cited by
92
References
14
Citations by year
2025: 2 · 2023: 2 · 2022: 1 · 2021: 4 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 8 · 2015: 2 · 2014: 3 · 2013: 7 · 2012: 7
FWCI
0.93
Type
journal article
Language
en
Open access
closed
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations
  • American Journal of Respiratory and Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
hypothyroidism, obstructive sleep apnea, sleep-disordered breathing, misdiagnosis, thyroid screening, thyroxine therapy, polysomnography, thyroid hormone assay, nocturnal hypoxia, sleep clinic patients
MeSH terms
Adult, Alberta, Diagnosis, Differential, Female, Humans, Hypothyroidism, Male, Mass Screening, Middle Aged, Sleep Apnea Syndromes, Thyroid Function Tests, Comorbidity

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