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Investigation of the frequency of obstructive sleep apnoea syndrome in patients with subclinical hypothyroidism

Aysegul Gencer, Ersan Atahan, Pinar Kadioglu, Birsen Mutlu
ERJ Open Research 2022 8: 00186-2022; DOI: 10.1183/23120541.00186-2022
Aysegul Gencer
1Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey
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  • ORCID record for Aysegul Gencer
  • For correspondence: aysegulbozkurtgencer@gmail.com
Ersan Atahan
1Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey
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Pinar Kadioglu
2Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Endocrinology – Diabetes and Metabolism Diseases, Istanbul, Turkey
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Birsen Mutlu
1Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey
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  • FIGURE 1
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    FIGURE 1

    Distribution of oxygen desaturation index values in the patient and the control groups.

Tables

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  • TABLE 1

    Distribution of variables

    VariablesStudy groupControl groupp-value
    Subjects, n6060
    Sex, n (%)
     Female27 (45)26 (43)0.523
     Male33 (55)34 (57)
    Age years, mean±sd50.57±11.4953.07±11.550.237#
    Pack-years smoking0.032¶
     Mean±sd10.90±16.3716.52±21.29
     Median (1st–3rd quartile)0 (0–15)13.5 (0–25.5)
    BMI kg·m−2
     Mean±sd31.84±5.6531.89±7.20.914¶
     Median (1st–3rd quartile)31.25 (27.92–36.15)30.97 (28–34.7)
    BMI category, n (%)
     Obese5 (8)6 (10)0.945
     Overweight23 (38)22 (37)
     Normal32 (53)32 (53)
    Neck circumference cm
     Mean±sd40.04±4.0340.82±3.770.131¶
     Median (1st–3rd quartile)39 (38–42)41 (38.25–43)
    Comorbidities, n (%)
     Hypertension17 (28)24 (40)
     Diabetes mellitus11 (18)9 (15)
     Coronary artery disease5 (8)12 (20)
     Asthma4 (7)4 (7)
     COPD2 (3)1 (2)

    Continuous data were expressed as mean±sd and median (1st–3rd quartile). BMI: body mass index. #: independent samples t-test; ¶: Mann–Whitney U test.

    • TABLE 2

      Distribution of polysomnography data

      Study group#Control group#
      VariablesMean±sdMedian (1st quartile–3rd quartile)Mean±sdMedian (1st quartile–3rd quartile)p-value
      ESS scores7.4±5.566 (3.5–9.5)7.18±5.196 (3–10)0.837
      OSAS categories, n (%)0.786
       Normal6 (10)4 (7)
       Mild11 (18)14 (23)
       Moderate23 (38)20 (33)
       Severe20 (33)22 (37)
      Total sleep time min349.17±60.58352 (305.5–397)345.91±78.13354 (280–409)0.021¶
      Stage N1%6.13±4.884.4 (2.8–8)7.62±3.597.7 (4.7–9.4)0.017
      Stage N2%61.42±11.459.1 (51.95–67.95)59.1±11.4856.6 (49.4–67.5)0.947¶
      Stage N3%20.63±11.1319.8 (13.3–26.9)18.27±9.5318.65 (12.5–24.5)0.203
      REM sleep time min46.68±20.944 (35–60)54.4±33.4245.25 (30–79)0.397
      REM %13.45±6.0213.1 (10.2–16.3)15.43±8.0715.75 (9.6–21.8)0.116
      Arousal index15.05±11.6313.65 (7–20.5)10.58±9.999.3 (2.1–16.7)0.047
      AHI events·h−128.18±22.6223.5 (12.9–34.35)28.27±20.8222 (12.25–37.9)0.908
      RDI events·h−129.95±24.3919.8 (11.3–47.8)40.22±23.1441.3 (17.6–60.2)0.053
      REM-AHI30.81±26.8527 (6.8–53.9)22.11±22.8117.9 (0–40)0.041
      Supine-AHI14.03±20.115.6 (1.1–15.3)10.58±17.420.2 (0–20.3)0.016
      ODI events·h−126.39±29.2318.65 (6.65–32.65)16.52±21.296.55 (1.25–22.25)0.002
      Mean Spo293.33±4.4694 (93–95)93.31±2.6794 (92–95)0.359
      Minimum Spo283±9.4186 (83–89)83±9.0586 (80–89)0.695
      T90%6.65±14.160.85 (0.2–3.6)9.19±15.281.9 (0.2–9.1)0.320
      T80%2.27±7.720 (0–0)1.65±7.570 (0–0)0.995
      Mean apnoea duration s17.58±7.3215.4 (13.2–21.35)18.23±9.7417.65 (12.8–23.9)0.615
      Mean hypopnoea duration s29.34±8.727.95 (22.25–34.75)29.1±6.9228.2 (24.2–32.6)0.873
      MAD s26.93±7.026.7 (20.9–30.85)30.18±12.9726.9 (24.2–32.8)0.347

      Continuous data were expressed as mean±sd and median (1st–3rd quartile). ESS: Epworth Sleepiness Scale; OSAS: obstructive sleep apnoea syndrome; N1: non rapid-eye movement sleep stage 1; N2: non rapid-eye movement sleep stage 2; N3: deepest non rapid-eye movement sleep stage 3; REM: rapid eye movement; AHI: apnoea–hypopnoea index; RDI: respiratory disturbance index; ODI: oxygen desaturation index; Spo2: oxygen saturation measured by pulse oximetry; T90: oxygen saturation <90%; T80: oxygen saturation <80%; MAD: mean apnoea–hypopnoea duration. #: n=60; ¶: independent samples t-test was used, Mann-Whitney U test was used in other analyses. Bold font indicates p<0.05.

      • TABLE 3

        Significant factors of the subclinical hypothyroidism, multiple logistic regression analysis (Backward Stepwise, step 12)

        β coefficientStandard errorWaldp-valueExp(β)95% confidence interval for Exp(β)
        Sex (reference: female)−1.0290.4545.1360.0230.3580.147–0.87
        Min SpO20.1050.0397.3050.0071.1111.029–1.199
        ODI0.0520.0188.1080.0041.0531.016–1.092
        Constant−7.7043.4574.9660.0260

        Dependent variable: subclinical hypothyroidism; Nagelkerke R2=0.288. SpO2: oxygen saturation measured by pulse oximetry; ODI: oxygen desaturation index.

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        Investigation of the frequency of obstructive sleep apnoea syndrome in patients with subclinical hypothyroidism
        Aysegul Gencer, Ersan Atahan, Pinar Kadioglu, Birsen Mutlu
        ERJ Open Research Oct 2022, 8 (4) 00186-2022; DOI: 10.1183/23120541.00186-2022

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        Investigation of the frequency of obstructive sleep apnoea syndrome in patients with subclinical hypothyroidism
        Aysegul Gencer, Ersan Atahan, Pinar Kadioglu, Birsen Mutlu
        ERJ Open Research Oct 2022, 8 (4) 00186-2022; DOI: 10.1183/23120541.00186-2022
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