OBSTRUCTIVE SLEEP-APNEA SYNDROME AND ACROMEGALY

Obstructive sleep apnea syndrome is a complex disorder that has been a ssociated with a variety of abnormalities of the upper airway, includi ng tonsil and adenoid hypertrophy, nasal obstruction, retrognathia, an d macroglossia. The cause of the airway obstruction in acromegaly is b elieved to be related to osseous and soft-tissue changes surrounding t he upper airway, which lead to narrowing and subsequent collapse durin g sleep. We describe the results of treatment in seven patients with b oth sleep apnea and acromegaly. Four patients were treated by transsph enoidal hypophysectomy alone with a resolution of sleep apnea syndrome . One underwent hypophysectomy followed by postoperative radiation the rapy, which reduced his apnea. Three patients underwent unsuccessful u vulopalatopharyngoplasty. Successful treatment of the primary disorder , in this case acromegaly, resulted in improved breathing during sleep in five patients. This series would suggest that acromegalic patients with sleep apnea should be treated for their pituitary tumor to reduc e growth hormone before consideration of surgery to enlarge or bypass the upper airway.