Kittle W M, Chaudhary B A
Department of Medicine, Medical College of Georgia, Augusta 30912-2623.
South Med J. 1988 Nov;81(11):1421-5. doi: 10.1097/00007611-198811000-00020.
Thyroid deficiency states are now a well recognized cause of the sleep apnea syndrome. The spectrum of disease ranges from mild, asymptomatic hypothyroidism to severe myxedema, and the disorder is associated with both obstructive and central types of sleep apnea. A variety of factors may be involved, including upper airway obstruction with or without obesity, and alterations in ventilatory drive. The definitive therapy is thyroid hormone replacement, which has been shown to diminish or completely eliminate apneic episodes and arterial oxygen desaturation, as well as to effect many improvements in sleep patterns and overall sleep efficiency. The incidence of thyroid deficiency states in patients with sleep apnea syndrome is not known, but it seems reasonable to evaluate thyroid function in all patients. Thyroid replacement therapy seems logical for the treatment of sleep apnea in patients with previously unrecognized subclinical hypothyroidism. Much remains to be learned about the diagnosis and treatment of sleep apnea syndromes associated with thyroid hormone deficiency, and further studies are needed.
甲状腺功能减退状态如今是睡眠呼吸暂停综合征一个已得到充分认识的病因。疾病范围从轻度无症状甲状腺功能减退到重度黏液性水肿，且该病症与阻塞性和中枢性睡眠呼吸暂停均相关。可能涉及多种因素，包括伴有或不伴有肥胖的上气道阻塞以及通气驱动力改变。明确的治疗方法是甲状腺激素替代治疗，已证明该治疗可减少或完全消除呼吸暂停发作及动脉血氧饱和度下降，还能在睡眠模式和整体睡眠效率方面带来诸多改善。睡眠呼吸暂停综合征患者中甲状腺功能减退状态的发生率尚不清楚，但对所有患者评估甲状腺功能似乎是合理的。对于先前未被识别的亚临床甲状腺功能减退患者，甲状腺替代治疗似乎是治疗睡眠呼吸暂停的合理方法。关于与甲状腺激素缺乏相关的睡眠呼吸暂停综合征的诊断和治疗，仍有许多有待了解之处，需要进一步研究。
