Acromegaly is often associated with sleep apnea-hypopnea syndrome (SAHS). The purpose of this study was to understand the prevalence of SAHS in patients with acromegaly and define the characteristics of acromegalic patients with and without SAHS.

The study enrolled 17 patients (11 women and 6 men) residing in the province of Ourense, Spain, who were diagnosed with acromegaly. All patients underwent overnight polysomnography in a sleep laboratory. In addition, growth hormone and insulin-like growth factor 1 levels were assessed. Sixteen of the patients underwent cephalometric study.

The average age of the patients was 58 years (95% confidence interval [CI], 52-63). The average body mass index was 31 (95% CI, 29-34) and average neck circumference was 41 (95% CI, 39-43). Ten patients (58.8%) had an apnea-hypopnea index (AHI) greater than 10. Nine had obstructive apnea and one had central apnea. Seven (5 with an AHI>10 and 2 with an AHI<10) reported excessive daytime sleepiness with Epworth scores greater than 10 (41.2%). Five patients (29.4%) were diagnosed with SAHS (AHI>10 and Epworth>10). No correlation was found between an AHI greater than 10 and hormonal activity (P = .082). The mean growth hormone level for patients with an AHI greater than 10 was 4.8 (95% CI, 0.5-9) and the mean for those with an AHI less than 10 was 12 (95% CI, 2-27). Fifty percent of the patients were treated with a somatostatin analog and half of those treated exhibited apnea (P = .302). No cephalometric differences related to the presence of apneas were found.

We found a high prevalence of sleep apneas (58.8%) and SAHS (29.4%), and central apneas were rare. We found no correlation between hormone activity level and the presence of SAHS. The incidence of SAHS was the same in somatostatin analog treated and untreated patients. Cephalometric variables did not distinguish between acromegalic patients with and without SAHS.

La acromegalia se relaciona frecuentemente con el síndrome de apnea-hipopnea del sueño (SAHS). El propósito de este trabajo es conocer la prevalencia del SAHS en los pacientes con acromegalia y definir las características de esta población con y sin SAHS.

Se estudió a 17 pacientes diagnosticados de acromegalia en la provincia de Ourense (11 mujeres y 6 varones). A todos ellos se les realizó polisomnografía nocturna diagnóstica en el laboratorio del sueño, además de una determinación de hormona de crecimiento y de factor 1 de crecimiento insulina-like, y a 16 se les efectuó un estudio cefalométrico.

La edad media de los pacientes era de 58 años (intervalo de confianza [IC] del 95%, 52-63). La media del índice de masa corporal era de 31 (IC del 95%, 29-34) y la del perímetro del cuello, de 41 (IC del 95%, 39-43). Diez pacientes (58,8%) tenían un índice de apnea-hipopnea (IAH) mayor de 10; 9 presentaban apnea obstructiva y 1, central. Del total de pacientes, 7 (5 con IAH > 10 y 2 con IAH < 10) presentaban somnolencia diurna excesiva, con un índice de Epworth superior a 10 (41,2%). Presentaban SAHS (IAH > 10 y Epworth > 10) 5 pacientes (29,4%). No se encontró relación entre un IAH mayor de 10 y actividad hormonal (p = 0,082). Los sujetos con IAH mayor de 10 presentaban un valor medio de hormona de crecimiento de 4,8 (IC del 95%, 0,5-9) y en aquellos con IAH menor de 10 dicho valor era de 12 (IC del 95%, 2-27). Estaban tratados con análogos de la somatostatina el 50% de los pacientes, de los cuales la mitad presentaba apnea (p = 0,302). El estudio completo de las cefalometrías no evidenció diferencia en relación con la presencia de apneas.

Encontramos una alta prevalencia de apnea del sueño (58,8%) y de síndrome de apnea del sueño (29,4%), y fue una rareza la presencia de apneas centrales. No encontramos relación entre actividad hormonal y la presencia de SAHS. Los pacientes tratados con análogos de la somatostatina presentaban la misma incidencia de SAHS que los no tratados. Ningún parámetro de cefalometría resultó discriminador.