Hypothyroidism and Sleep Apnea

[LavenderMist]

I was researching about hypothyroidism (Hashimoto's Disease) and came across this article. Thought I'd pass it along for anyone interested. I have Hashimoto's as well as OSA among other health conditions. All the dots are starting to connect. Now if the doctors could just connect them too!
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First Reported Death From Hypothyroidism and Sleep Apnea. In 1999, doctors reported the first case of a hypothyroid patient who suddenly died from sleep apnea.[4] The patient was a 48-year-old man who was short and slightly overweight. He had never been treated for his hypothyroidism.

For several years, the patient suffered from air hunger at night. In the previous few weeks, his air hunger had worsened. In the hospital, doctors noted that he was lucid, but his mental and physical functions were slow. They found that he had a multinodular goiter that had moved his windpipe (trachea) from its normal position. His tongue was enlarged, and his pharynx (the cavity that connects the mouth and nasal passages to the esophagus) was swollen with edema. His blood was adequately saturated with oxygen at 97%.

Doctors treated the man with T3 and hydrocortisone. They doubted that he had sleep apnea syndrome (SAS), but they applied pulse oximetry. (Pulse oximetry is a monitor, usually with a finger sensor, used during anesthesia and critical care. It measures oxygen saturation of arterial blood.) The man suddenly died seven hours later.

The oximetry record showed that over the seven-hour period, the patient had prolonged episodes of sleep apnea. These episodes had caused deep drops in oxygen saturation of his blood. The doctors who reported the man’s death urged other doctors to promptly diagnose hypothyroidism that’s associated with obstructive sleep apnea. They noted that the condition can become serious and require intensive care with continuous nasal airway positive pressure. They wrote that some patients may need tracheal intubation with assisted ventilation. They cautioned, "Continuous cardiac monitoring should also be carried out, given the risk for acute coronary complications and ventricular arrhythmias in the early phases of substitutive therapy with thyroid hormone."

Conclusion: The studies I’ve cited in this report show that too little thyroid hormone regulation can cause a variety of breathing problems. These range from mere frustrating air hunger to death from sleep apnea. If you have a breathing problem and your doctor can’t find the cause, ask him or her to evaluate you for hypothyroidism or thyroid hormone resistance. If you’re being treated for hypothyroidism with T4-replacement, ask your doctor to consider that this thyroid hormone therapy leaves almost 50% of patients suffering from chronic hypothyroid symptoms.[31] Ask your doctor to also consider that you may need to switch to a more effective therapy such as a T4/T3 combination product or T3 alone. At minimum, if your doctor isn’t aware that too little thyroid hormone regulation can cause breathing problems, share this special report with him or her. The doctor may use the information not only to relieve your breathing problem, but to help other patients, too.

source: http://www.drlowe.com/jcl/comentry/brea ... oblems.htm

[LavenderMist]

More on the subject..
http://www.chestjournal.org/content/102/6/1663.abstract

[napagirl]

WOW! this is interesting. My "borderline" hypothyroidism was diagnosed after my pregnancy. That is also when I developed OSA. I am not currently taking the thyroid meds cause they made me feel too wired. But I am going to revisit this with the dr. He said there are some beta blockers they can give to slow the heart down if one is sensitive to starting the meds.

[elg5cats]

quote]LavenderMist"]I was researching about hypothyroidism[/quote] I read a article about a study at Duke University wy/ a hypothesis untreated hypothyroidism caused OSA and treating hypoT resulted in resolution of OSA. It was a relative small sample for the study. They did have a few patients who had resolved OSA when HypoT was effectively treated. One of research points to decide if all patients should have a work up for HypoT prior to having a sleep study or as a part of the work up for OSA. The conclusion was is was not cost effective. The subjects in the sample had not had previous diagnosis of HypoT.

I personally find the dual fatigue associated with HypoT and OSA a management challenge. My sleep MD stated tissue changes with thyroid disease can aggravate OSA...he didn't go as far to say there is a direct cause and effect between OSA/HypoT.

elg5cats

[howkim]

I am not currently taking the thyroid meds cause they made me feel too wired. But I am going to revisit this with the dr. He said there are some beta blockers they can give to slow the heart down if one is sensitive to starting the meds.

You also don't have to start with the full replacement dose. Talk to the doc about starting at a fraction of the dose he wants you on and build it up to the full dose over several weeks. When you reach the full dose prescribed, stay on it consistently for 6-8 weeks and then retest (not before). It takes a LONG time (6-8 weeks) for thyroid hormone to reach a stable level in the blood with dosing at a consistent level and taking the pills consistently.

[Kiralynx]

One of research points to decide if all patients should have a work up for HypoT prior to having a sleep study or as a part of the work up for OSA. The conclusion was is was not cost effective. The subjects in the sample had not had previous diagnosis of HypoT.

Interestingly, I was sent for a TSH test before they would let me do a sleep study.

[BlackSpinner]

My doctor tests all her patients for thyriod issues. She has it herself and knows how long it can take to detect if they don't check for it. It is a simple blood test she arranges to have done with the other annual blood tests I get done. This was good because she diagnosed my daughter immediately and discovered that a lot of her emotional issues were actually thyriod related. It drives her crazy to think there are lots of people out there on basically the wrong medication for years (like her) just because other doctors neglect this simple test.

[krazykchan]

It drives her crazy to think there are lots of people out there on basically the wrong medication for years (like her) just because other doctors neglect this simple test.

That is very aggravating! My ex doctor would much rather put me on anti-depressants then check my thyroid. I did convince her to check my TSH levels and she said they were fine so I went on the anti-depressants.

A few years later, I'm much smarter about hypothyroidism. My ex doctor was going off the old standard of any TSH level under a 5 is normal. (My current Endocrinologist wants me under 2.) I'm doing much better on thyroid meds than I ever did on antidepressants. I am not sure if my hypothyroidism is related to my OSA or not. As I am not really sure how long I've had the OSA. Maybe I got them both at the same time. Who knows.

[LavenderMist]

I'm not really sure if one causes the other. I did have Hashi for many years before the OSA diagnosis. However, I am sure that one affects the other in a negative way when they coexist. Thus, it would be prudent to receive optimal treatment for both to feel your best (cpap and thryoid hormone replacement). Our bodies are amazingly complex.

[BeanMeScot]

I was diagnosed Hypothyroid about 12 years before my OSA diagnosis. I was put on Synthroid and was stable for about 8 weeks, then my TSH was up again so my doctor changed the dose. That's the last time my dose was changed. I have my blood pulled farily often because of cholestrol lowering medication and she always checks my TSH at the same time.

[robertmarilyn]

[quote="LavenderMist"]I was researching about hypothyroidism (Hashimoto's Disease) and came across this article. Thought I'd pass it along for anyone interested. I have Hashimoto's as well as OSA among other health conditions. All the dots are starting to connect. Now if the doctors could just connect them too!
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Thanks for posting this...I have hypothyroidism (Hashimoto's Disease) and have no idea how long I had it before I knew I had it...my TSH test came back at a whopping 187...no wonder I felt like a zombie and could have slept 24/7 if I didn't feel so guilty doing it.

I have a ways to go before I am sure it is being treated properly...I am still very cold and tired even though my last test read 2.7.

mar

[garyland]

Hi All,

I am one of the few men on the planet that has Hashimoto's Thyroiditis. I take Armour thyroid and have from the start (about 5 years ago).

Gary

[PkSteph]

That's just sad!

I've been diagnosed hypothyroid about 10 years ago, but, I knew it was probably going to happen sometime. I had a goiter back when I was 12 years old. My thyroid had swollen to twice the normal size. Ugh.. I remember feeling like I was choking all the time! My doc said I wasn't hypo at the time, but, I probably will be in the future.

Good luck finding a doctor who will give patients T-3. I went for about 2 years after diagnosis on Synthroid and I felt like CRAP. It took me 5 doctors to find one who would give my Armour thyroid pills. Then it took a couple more who wouldn't under-treat me. I wish they weren't so freaking scared of making people hyper. It's really annoying when most of them are clueless (even endos!) that A LOT of people on Armour actually feel better when their TSH is suppressed. (It's almost too much to ask some for T-3 labs).... I feel better when my TSH is around 0.02. lol

[Grieving sister]

My 29 year old brother was just diagnosed with hypothyroidism and sleep apnea about a month ago and then died on May 1, 2017.

[LSAT]

My 29 year old brother was just diagnosed with hypothyroidism and sleep apnea about a month ago and then died on May 1, 2017.

You have my condolences...What was the connection between the two? What did he die from?