SLEEP-APNEA IN TREATED ACROMEGALY - RELATIVE FREQUENCY AND PREDISPOSING FACTORS

OBJECTIVES Sleep apnoea is common in active acromegaly. It is associat ed with increased morbidity and mortality but can be treated effective ly. The objective of this study was to determine the largely unknown r elative frequency of, and the predictive factors for, sleep apnoea in treated acromegalic patients. DESIGN Retrospective cohort study. SETTI NG Tertiary referral hospital. PATIENTS Fifty-four of 100 patients wit h treated acromegaly. If sleep apnoea had been diagnosed before acrome galy, the patient was excluded. MEASUREMENTS Sleep studies (using the MESAM-4 device measuring oxyhaemoglobin saturation, heart rate, snorin g sounds and body position to determine presence and severity of sleep apnoea); GH and IGF-I levels; body mass index, neck and index-finger circumference; daytime symptoms of sleep apnoea, duration of acromegal y before treatment, shoe and neck-sire difference since beginning of a cromegaly; age, sex and treatment modes of acromegaly. RESULTS The rel ative frequency of sleep apnoea was 39% in the 54 patients with sleep studies and at least 21% in the entire study population of 100 patient s. In patients with sleep apnoea, statistically significant higher val ues were observed for GH (P = 0.002), IGF-I (P = 0.029), age (P = 0.01 4) and neck circumference (P = 0.016). An index-finger circumference o f greater than or equal to 8.5 cm was associated with a significantly higher desaturation index (P = 0.012, Mann-Whitney U-test). Adenomecto my had been performed significantly less frequently in patients with s leep apnoea (P < 0.001, chi(2) test). The body mass index was non-sign ificantly higher in the patients with sleep apnoea. CONCLUSIONS The re lative frequency of sleep apnoea in patients with treated acromegaly i s at least 21%. Parameters of predictive value for the presence of sle ep apnoea in this population are neck and index-finger circumference a s measures of soft tissue hypertrophy, age, GH and IGF-I levels, and w hether or not operative therapy was applied.