Obstructive Sleep Apnea Syndrome Is Less Frequent in Patients With Well-Controlled Acromegaly Treated With Somatostatin Analogues, Pegvisomant or in Combination
Obstructive sleep apnea (OSA) often occurs in patients with active acromegaly and improves after treatment. Less is known about the development of OSA in patients after a longer period of control treated with somatostatin analogues (SSA) and pegvisomant.
Seventy-nine patients (12 females, 17 males; age 49 ± 14 years; body mass index 29.9 ± 5.4 kg/m2; IGF-1 184 ± 73 μg/L; disease duration 13 ± 8 years (mean ± standard deviation)) with wellcontrolled acromegaly treated with SSA (38%), pegvisomant (38%) or in combination (24%) who underwent ambulatory polygraphy were included in a prospective multicenter cross-sectional study.
Fourteen percent had OSA (range of apnea-hypopnea index (AHI) 5 - 15). Patients with OSA (AHI ≥ 5 vs. < 5) had a longer disease duration (16 ± 1 vs. 12 ± 8 years; P = 0.01) and were older (61 ± 9 vs. 47 ± 13 years; P = 0.037). The AHI of all patients correlated with age (P = 0.01; r = 0.44). No differences were seen in terms of BMI and Epworth sleepiness scale score. Previous transsphenoidal surgery and radiation had no impact of the detection of OSA. The duration of well-controlled acromegaly was 7 ± 3 years.
OSA in patients with well-controlled acromegaly treated with SSA, pegvisomant or in combination is less frequent (14%) than previously described. Early treatment to reduce the active disease period should be aimed to prevent OSA.
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