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Nocturnal breathing abnormalities in acromegaly after adenomectomy
Author(s) -
Pelttari Lisa,
Polo Olli,
Rauhala Esa,
Vuorlluoto Jarkko,
Altasalo Kalle,
Hyyppä Markku T.,
Kronholm Erkkl,
Irjala Kerttu,
Viikari Jorma
Publication year - 1995
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1995.tb01912.x
Subject(s) - acromegaly , medicine , soft palate , airway obstruction , macroglossia , population , breathing , polysomnography , airway , apnea , surgery , tongue , anesthesia , pathology , growth hormone , environmental health , hormone
Summary objective The Incidence of sleep apnoea Is Increased In acromegaly. The aim of the study was to determine the occurrence of nocturnal breathing abnormalities and upper airway morphology In acromegalic patients some years after adenomectomy DESIGN A case‐control study PATIENTS Eleven patients with treated acromegaly and two control groups: (1) sleep studies: 197 subjects randomly selected from the population, (2) cephalometry: 27 healthy subjects and 17 patients with obstructive sleep apnoea MEASUREMENTS Nocturnal breathing was monitored with a static charge‐sensitive bed. The upper airway soft tissues and bone morphology were assessed by cephalometrlc X‐ray photography. The upper airway collapslblllty was Investigated with dynamic nasopharyngoscopy. Endocrinological investigations were also performed RESULTS Nocturnal breathing abnormalities were present In all but one acromegalic patient (91%), which was far more frequent than In the general population (29‐4%, P< ; 0‐0001). Treated acromegaly was the most powerful predictor of breathing abnormalities, Independent of the other significant predictors, age and body mass Index. The predominant breathing abnormality was periodic breathing with symmetrically waxing and waning respiratory effort without a major body movement component. Episodes of complete obstruction with repetitive arousals were rare. Except for the longer soft palate, the cephalometrlc findings were similar to normal. In comparison to obstructive sleep apnoea, the treated acromegalic patients had rather prognathic than retrognathlc mandibles. Flbreoptlc endoscopy in the acromegalic patients revealed collapsible upper airways at the level of the soft palate, whereas at the base of the tongue little, If any, dynamic narrowing was observed. CONCLUSION Our study confirms that nocturnal breathing abnormalities are common In treated acromegaly, and may persist years after the removal of the G H secreting tumour. The breathing abnormalities and the upper airway morphology in acromegalic patients after adenomectomy are different from those observed In primary obstructive sleep apnoea, suggesting a different pathophysiology of the airway obstruction