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Obstructive Sleep Apnea in Hypothyroidism

KRISHNAN R. RAJAGOPAL, M.D.; PETER H. ABBRECHT, M.D., Ph.D.; SARKIS S. DERDERIAN, D.O.; CHERYL PICKETT, B.S.; FRED HOFELDT, M.D.; CLAUDE J. TELLIS, M.D.; and CLIFFORD W. ZWILLICH, M.D.
[+] Article and Author Information

Grant support: by protocol 1700 from Walter Reed Army Medical Center; grant R07648 from the Uniformed Services University of the Health Sciences; and grants HL14985 and HE05933 from the National Institutes of Health.

The opinions and assertions contained herein are the private views of the writers and are not to be construed as official or as reflecting the views of the Department of the Army and the Department of Defense.

▸Requests for reprints should be addressed to Krishnan R. Rajagopal, M.D.; Pulmonary Disease Service, Department of Medicine, Walter Reed Army Medical Center; Washington, DC 20307.


Washington, D.C.; Bethesda, Maryland; and Denver, Colorado


Ann Intern Med. 1984;101(4):491-494. doi:10.7326/0003-4819-101-4-491
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To determine the incidence and frequency of sleep apnea in persons with hypothyroidism, 11 consecutive patients with newly diagnosed disease were studied before and during thyroid hormone replacement therapy. Nine patients had episodes of apnea, with the number of episodes per hour of sleep ranging from 17 to 176 (mean, 71.8). Six of the nine patients were obese and had 99.5 episodes per hour compared with 16.3 episodes per hour in the 3 nonobese patients (p < 0.02). After 3 to 12 months of thyroxine replacement therapy, mean apnea frequency decreased from 71.8 ± 18.0 (SE) to 12.7 ± 6.1 episodes per hour, without reduction in body weight. There were fewer changes in sleep stage per hour during treatment (22.1 ± 4.9) than pretreatment (57.6 ± 14.5). Carbon dioxide response tests done under non-loaded and flow-resistive loaded conditions before and during thyroxine replacement therapy showed increases in the loaded respiratory effort and ventilation during thyroxine treatment. Sleep apnea episodes are common in persons with untreated hypothyroidism, even with normal lung function. Thyroxine replacement therapy decreases apnea frequency, even without change in body weight.

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