title: Sleep apnoea in treated acromegaly: relative frequency and predisposing factors.
abstract: OBJECTIVE
  Sleep apnoea is common in active acromegaly. It is associated with increased morbidity and mortality but can be treated effectively. The objective of this study was to determine the largely unknown relative frequency of, and the predictive factors for, sleep apnoea in treated acromegalic patients.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tertiary referral hospital.
  
  
  METHODS
  Fifty-four of 100 patients with treated acromegaly. If sleep apnoea had been diagnosed before acromegaly, the patient was excluded.
  
  
  METHODS
  Sleep studies (using the MESAM-4 device measuring oxyhaemoglobin saturation, heart rate, snoring sounds and body position to determine presence and severity of sleep apnoea); GH and IGF-I levels; body mass index, neck and index-finger circumference; daytime symptoms of sleep apnoea, duration of acromegaly before treatment, shoe and neck-size difference since beginning of acromegaly; age, sex and treatment modes of acromegaly.
  
  
  RESULTS
  The relative frequency of sleep apnoea was 39% in the 54 patients with sleep studies and at least 21% in the entire study population of 100 patients. In patients with sleep apnoea, statistically significant higher values were observed for GH (P = 0.002), IGF-I (P = 0.029), age (P = 0.014) and neck circumference (P = 0.016). An index-finger circumference of > or = 8.5 cm was associated with a significantly higher desaturation index (P = 0.012, Mann-Whitney U-test). Adenomectomy had been performed significantly less frequently in patients with sleep apnoea (P < 0.001, X2 test). The body mass index was non-significantly higher in the patients with sleep apnoea.
  
  
  CONCLUSIONS
  The relative frequency of sleep apnoea in patients with treated acromegaly is at least 21%. Parameters of predictive value for the presence of sleep apnoea in this population are neck and index-finger circumference as measures of soft tissue hypertrophy, age, GH and IGF-I levels, and whether or not operative therapy was applied.
authors.affiliation: Department of Neurology, University of Cologne, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Rosenow
authors.forename: S
authors.initials: S
authors.lastname: Reuter
authors.forename: U
authors.initials: U
authors.lastname: Deuss
authors.forename: B
authors.initials: B
authors.lastname: Szelies
authors.forename: R D
authors.initials: RD
authors.lastname: Hilgers
authors.forename: W
authors.initials: W
authors.lastname: Winkelmann
authors.forename: W D
authors.initials: WD
authors.lastname: Heiss
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000150:complications* / Q000601:surgery; D000328:Adult; D000367:Age Factors; D005260:Female; D005385:Fingers / Q000033:anatomy & histology; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D009333:Neck / Q000033:anatomy & histology; D012189:Retrospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000097:blood / Q000150:complications*
chemical_list: D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone