Does hormonal control obviate positive airway pressure therapy in acromegaly with sleep-disordered breathing?

• Published in: Respiratory medicine 2013-11, Vol.107 (11), p.1803-1809
• Main Authors: Akkoyunlu, Muhammed Emin, İlhan, Mahmut Muzaffer, Bayram, Mehmet, Taşan, Ertuğrul, Yakar, Fatih, Özçelik, Hatice Kutbay, Karakose, Fatmanur, Kart, Levent
• Format: Article
• Language: English
• Subjects: Acromegaly; Acromegaly - blood; Acromegaly - complications; Acromegaly - therapy; Adult; Age; Anthropometry - methods; Biomarkers - blood; Body mass index; Female; Growth hormones; Human Growth Hormone - blood; Humans; Hypertension; Insulin; Insulin-Like Growth Factor I - metabolism; Insulin-like growth factors; Male; Middle Aged; PAP therapy; Patients; Polysomnography - methods; Positive-Pressure Respiration - methods; Pulmonary/Respiratory; Radiation therapy; Severity of Illness Index; Sleep apnea; Sleep Apnea Syndromes - blood; Sleep Apnea Syndromes - etiology; Sleep Apnea Syndromes - therapy; Sleep disordered breathing; Sleep disorders; Studies; Surgery
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2013.08.043

Summary Introduction Acromegaly is a disease in which uncontrolled release of growth hormone occurs after closure of epiphyseal plates, causing changes in the body that can lead to sleep disordered breathing (SDB). No definite guidelines regarding the treatment of SDB in acromegaly are available. In this study, we aimed to investigate the prevalence of SDB in acromegaly and whether hormonal control alters the necessity of positive airway pressure (PAP) therapy in acromegaly patients with SDB. Methods Forty-two acromegaly patients were included in the study and divided into two groups according to disease status, i.e., active or well controlled. All patients underwent polysomnography. Fourteen patients with active acromegaly were diagnosed with SDB and were evaluated for PAP therapy with polysomnography both before and 6 months after disease control was achieved. Results Sleep-disorder breathing was diagnosed in 22 of 42 patients, 7 of 20 patients with controlled-disease and 15 of 20 patients with active diseases. There were significant reductions in respiratory disturbance index (RDI), apnea index, desaturation index, central apnea number, and rapid eye movement-phase RDI at the control polysomnography. Initially, PAP therapy was indicated in 12 of 14 patients and PAP therapy indication held in 11 patients after acromegaly control was achieved. Conclusion Our study revealed that over half of patients with acromegaly had SDB. Furthermore, SDB severity decreases with acromegaly treatment; however, this decrease does not change the indication for PAP therapy; therefore, PAP therapy should not be delayed in acromegalic SDB patients.