RESEARCH ARTICLE


Sleep Apnea in Patients with Acromegaly. Frequency, Characterization and Positive Pressure Titration



Daniel Hernández-Gordillo 1, María del Rocío Ortega-Gómez 2, Lourdes Galicia-Polo 1, Armando Castorena-Maldonado 1, Alma Vergara-López 2, Miguel Ángel Guillén-González 2, Luis Torre-Bouscoulet*, 1, 3
1 Sleep Medicine Unit, National Institute of Respiratory Diseases; Mexico City, Mexico
2 Department of Endocrinology, Centro Médico Nacional “20 de Noviembre”; Mexico City, Mexico
3 Department of Respiratory Physiology, National Institute of Respiratory Diseases; Mexico City, Mexico


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© Hernández-Gordillo et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Departamento de Fisiología Respiratoria y Clínica de Trastornos Respiratorios del Dormir, Instituto Nacional de Enfermedades Respiratorias, Tlalpan 4502, Colonia Sección XVI, Delegación Tlalpan CP 14080, D.F. México; Tel/Fax: (52) (55) 5665- 4748; E-mail: luistorreb@gmail.com


Abstract

Objectives:

  1. to describe the frequency of sleep apnea in patients with acromegaly;
  2. to identify the proportion of candidates for treatment with positive airway pressure;
  3. to report our experience with the positive pressure titration process in acromegaly patients.

Methods:

A cross-sectional study that included the acromegaly cohort at the Centro Medico Nacional 20 de Noviembre” in Mexico City (n=44). A standard polysomnography (PSG) was carried out for each patient. A second PSG was done for purposes of CPAP titration.

Results:

A total of 35 patients were studied (80% of the cohort, 20 [57%] women). Polysomnography results showed that 34 subjects (97%, 95%CI 91-100%) had apnea hypopnea indexes (AHI) ≥ 5. No patient had central apnea. We identified 19 subjects with AHI ≥5 and Epworth ≥10, for a frequency of obstructive sleep apnea syndrome of 54% (95%CI 36-71%). A total of 31 patients (88%; 95%CI 77-99%) were deemed to be candidates for positive pressure treatment, but only 8 of them accepted CPAP. They required pressures that ranged from 10 to 18 cmH2O.

Conclusions:

Our results confirm a high prevalence of sleep apnea in patients with acromegaly, and provide evidence that the majority of those patients are candidates for treatment with positive pressure. Contrary to what has been reported, we identified no patients with central apnea.

Keywords: Acromegaly, sleep, sleep apnea, sleep-disordered breathing, growth hormone..