Teramoto S, Ohga E, Katayama H, Matsui H, Tomita T, Matsuse T, Fukuchi Y, Ouchi Y
Department of Geriatrics, Faculty of Medicine, University of Tokyo, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Jul;36(7):590-4.
Because the incidence of sleep apnea is known to increase in both hypothyroidism and with age, elderly hypothyroid patients may experience more sleep apnea than younger hypothyroidism patients. However, the features of nocturnal disturbed breathing in elderly hypothyroid patients have not been fully elucidated. Concise polysomnographic studies including respiratory movement and oxyhemoglobin saturation (SaO2) were done on 18 elderly subjects with hypothyroidism (73.6 +/- 5.9 years old) before and after thyroid hormone replacement therapy. Fourteen of the patients exhibited a significant incidence of nocturnal apnea. Lower incidence of nocturnal apnea and higher nocturnal nadir SaO2 were observed in the patients 3 to 6 months after thyroxine therapy. Although the levels of thyroid hormones returned to normal in the patients, 9 patients had more than 5 bouts of nocturnal apnea per hour after the hormone replacement therapy. Further, no relationship was found between the level of thyroid hormones and the frequency of nocturnal apnea. These results suggest that levels of thyroid hormones are not indicators of the potential severity of nocturnal apnea in elderly hypothyroid patients, and that sleep studies may be necessary to assess the efficacy of thyroid hormone replacement therapy in the treatment of nocturnal apnea.
由于已知睡眠呼吸暂停的发生率在甲状腺功能减退症患者以及随着年龄增长时都会增加，老年甲状腺功能减退症患者可能比年轻的甲状腺功能减退症患者经历更多的睡眠呼吸暂停。然而，老年甲状腺功能减退症患者夜间呼吸紊乱的特征尚未完全阐明。对18名老年甲状腺功能减退症患者（73.6±5.9岁）在甲状腺激素替代治疗前后进行了包括呼吸运动和氧合血红蛋白饱和度（SaO2）在内的简明多导睡眠图研究。其中14名患者夜间呼吸暂停发生率显著。在甲状腺素治疗3至6个月后，患者夜间呼吸暂停发生率降低，夜间最低SaO2升高。尽管患者的甲状腺激素水平恢复正常，但9名患者在激素替代治疗后每小时仍有超过5次夜间呼吸暂停发作。此外，未发现甲状腺激素水平与夜间呼吸暂停频率之间存在关联。这些结果表明，甲状腺激素水平并非老年甲状腺功能减退症患者夜间呼吸暂停潜在严重程度的指标，并且睡眠研究可能对于评估甲状腺激素替代治疗在治疗夜间呼吸暂停方面的疗效是必要的。
