Coexisting conditions...thyroid and sleep apnea??

[jjlady]

I wonder if there is a relationship with thyroid issues and sleep apnea? Are there lots of people that have both issues? I know lots of people don't do well on thyroid meds, could it be low oxygen (from sleep apnea) affects absorbtion of meds?

Also maybe nodules or enlarged thyroid affects breathing (causing sleep apnea)? I have both, hypothyroid and hashimotos and didn't do well on meds, then diagnosed with sleep apnea? Or maybe even misdiagnosis of one or the other? I guess I am reaching here.

It took me 4 years of suffering fatique with thyroid issues that wasn't improving with meds to me asking for a sleep study now I find out I have severe sleep apnea, did I always have it? Who knows? But then again, I am going through perimenopause, and have RA and have gained about 25 pounds over the last 3-4 years. Even RA could have been from thyroid, or other way around. I noticed my hand started to deform AFTER taking thyroid meds, that is why I got tested for RA, and the regular blood test came back negative, but they did a hand MRI to diagnose.

I tend to blame everything on the thyroid, now I have something new to blame things on...sleep apnea.....or did one cause the other?!

[avi123]

A thyroid condition is a known cause of OSA. See this:

http://ajrccm.atsjournals.org/content/158/5/1379.full


Association of Hypothyroidism and Obstructive Sleep Apnea

[brucifer]

A thyroid condition is a known cause of OSA. See this:

http://ajrccm.atsjournals.org/content/158/5/1379.full


Association of Hypothyroidism and Obstructive Sleep Apnea

AVI123, I have both OSA and hyperthyroidism, so I was interested in the article, even though the study that is discussed used data more than 20 years old. Anyway, I read the article. In no way do the authors of the article state or do the results of the study indicate that "A thyroid condition is a known cause of OSA."

What the authors were looking for was a general "relationship" between hypothyroidism and OSA, not a cause-and-effect relationship. They conducted the study to determine whether or not the results would justify doctors screening for hyperthyroidism prior to testing for OSA via a polysomnogram. Finding a simple relationship (correlation) between two variables within a 95% degree of confidence is a relatively easy thing to test when conducting a cross-sectional study. That being said, finding an actual "cause" is a much, much more difficult endeavor. For example, it is relatively easy to test and determine that there is a relationship between a rooster crowing and the sun rising each morning. Each event happens in the morning. The correlation is easy to determine. However, specifically linking WHY the sun rises and WHY the rooster crows requires a much more complex and specific set of hypotheses and tests. In short, determining cause-and-effect is much more difficult to find.

The authors of the article also mention some very important limitations to their cross-sectional study. For example, they state that the population of the case-group is too small (n=336) to establish a statistically-significant relationship. (The control-group population is fine [n=1,713].) The authors also state that some case-group subjects (patients) with hyperthyroidism may have been diagnosed with OSA without having had a polysomnogram.

Even with the limitations of the study, there was a finding of NO SIGNIFICANT DIFFERENCE between the Case-group and the Control-group. In the authors's own words, "Our study demonstrated that few new cases of hypothyroidism were discovered as a result of routine thyroid testing in a HMO population undergoing polysomnography for a suspected sleep disorder." That led the authors to conclude the following: "Based on our results, at present there is little evidence to support routine thyroid function testing by a sleep specialist prior to polysomnography in patients referred by a primary care provider."

AVI123, the bottom that is that the article does NOT support the idea that hypothyroidism causes OSA, and it does NOT support that there is even a correlation. I'm not saying that there is not a correlation, only that this paticular study does not support such.

The actual causes of hypothyroidism and OSA are still very open questions. Studies indicate that there is often a relationship (correlation) between body weight and OSA and body weight and hypothyroidism, but the underlying causes of OSA and hypothyroidism are still unknown.

[kteague]

Before and when I first started on CPAP, I had been tested annually because it was thought my weight gain and lethargy could be signs of a thyroid dysfunction. That was never verified as the panels never showed a problem. I didn't realize until reading here that an enlarged tongue is considered a sign a a thyroid problem. My tongue had for a while seemed almost too big for my mouth. I bit it frequently, and just keeping my mouth closed caused deep imprints or a ridge of teeth marks along both sides of the tongue. Several months after being on CPAP I noticed my tongue no longer felt crowded into my mouth.

I did a little reading after searching over on PubMed. Interesting reading but didn't run into anything really conclusive - some studies claim a correlation, others not. Surely the symptoms overlap and whether there was a causal effect either direction or not, it's understandable that an enlarged thyroid in the neck or an enlarged tongue could affect the airway. Some studies hypothesize that OSA can bring on autoimmune disorders. Sure don't have any answers here but look forward to reading if anyone else does.

http://www.ncbi.nlm.nih.gov/pubmed/22785371

[Goofproof]

Good news, pratcially anything you can think of befalls us Sleep Apnea suffers., feel free to blame all you ills to Sleep Apnea, it's sure to be among the causes, or just correctly treat Sleep Apnea, work to make all the other health problems better, and go down Lifes path. Many things we have don't have a cure, but things we do can make life better, for the time we have left. Jim

[nanwilson]

I have both....but..I was dx'd with the thyroid problem 40 years ago..I have a benign growth on my thyroid and have taken eltroxin for those 40+ years. I have only been on the hose for almost 2 1/2 years..and I did NOT snore and gasp until the last few years. From my perspective, there is no correlation between the two. I don't care what the disease is some scientist has written an article linking it to another....they HAVE to find a reason for something, if they can't find a reasonable cause, then something else HAS to be the reason. Blame it on sleep apnea .

[jen4700]

jjlady - were you ever treated with radioactive iodine?

I don't think there is a correlation between thyroid issues and OSA. But I don't think science knows enough about either to be sure. I had a sleep test before I was dx'd with thyroid cancer and did not have OSA. 5 years later after thyroidectomy, thyroid meds and several rounds of RAI treatment (and about 30 lbs more) I now have OSA. IMHO the structure of my throat was changed due to the surgery and the RAI treatment. The weight? I don't know. I'd "like" to think that I developed OSA and then put on the weight. But that's probably wishful thinking.

If you are doing well on cpap then stick with it! It can take months to really see the benefits from cpap therapy.

[sleeplessinaz]

Well I am not sure if one caused the other but I have hypothyroidism, then OSA then I got diabetes. I also had Vit D dificency too so somehow it is all related IMHO.

Carrie

[SleepDepraved2]

I had thyroid cancer, but my TSH levels were always in the "normal" range. No treatment except surgery because my very rare type of thyroid cancer (Hurthle cell) does not take up iodine.

But even before that, I always snored. I had problems with fatigue before the cancer diagnosis, but like I said, levels were normal. So chances are that the OSA was there before the diagnosis. But Hurthle Cell thyroid cancer grows really slow, so who knows what came first? I've been on a continuous steady dose of Synthroid ever since and it has made no difference to my fatigue level unless it was below where it should be, like when I got switched to generic by mistake. Then I could feel the difference.

[vze2363v]

Before and when I first started on CPAP, I had been tested annually because it was thought my weight gain and lethargy could be signs of a thyroid dysfunction. That was never verified as the panels never showed a problem. I didn't realize until reading here that an enlarged tongue is considered a sign a a thyroid problem. My tongue had for a while seemed almost too big for my mouth. I bit it frequently, and just keeping my mouth closed caused deep imprints or a ridge of teeth marks along both sides of the tongue. Several months after being on CPAP I noticed my tongue no longer felt crowded into my mouth.

I have the exact same problem! Both my mom and I are always biting our tongues - she's on thyroid medicine, but they keep testing mine because of my weight and it keeps coming up within acceptable parameters for normal thyroid. Both my sister and my brother have had their thyroids irradiated. (Once in my 20s I was diagnosed with low thyroid, but it wasn't a permanent thing and seemed to be solved with pills.) I HOPE my BiPAP helps as much as your CPAP did!

[lazer]

Strange thing is, about 4 years ago I was hypothyroid, then end of last year I was being diagnosed hyperthyroid. Had full scans - ultrasounds, ect... and found nothing of concern. I was just suggested to lower my (iodine) via any supplement vitamins by making sure they didn't contain over 100mg or whatever. Endocrinologist feels things are settled down as for now and no meds required either time. I wonder if these fluctuations have anything to do with my sleep disorder?

Note: I don't say OSA since my AHI tells my insurance company that I don't have OSA.

[lchwhiteiam]

I know this is an old post , but I'm researching Hashimotos & other symptoms & this popped up. I was diagnossed with Moderate sleep apnea right about the time i ws diagnosed hypothyroid. CPAP & all. I've been studying how diet ( IE Gluten, sugar, dairy, ) & leaky gut play a Major role in autoimmune disorders. Seems like a plan. Taking a pill & using a CPAP & still feeling like crap isnt working 4 me.

[PEF]

Strange thing is, about 4 years ago I was hypothyroid, then end of last year I was being diagnosed hyperthyroid. Had full scans - ultrasounds, ect... and found nothing of concern. I was just suggested to lower my (iodine) via any supplement vitamins by making sure they didn't contain over 100mg or whatever. Endocrinologist feels things are settled down as for now and no meds required either time. I wonder if these fluctuations have anything to do with my sleep disorder?

Note: I don't say OSA since my AHI tells my insurance company that I don't have OSA.

I also have both sleep apnea and Hashimoto's. I don't believe there is any type of causal relationship.

Hashimoto's is the most common type of Hypothyroidism. But it can also be characterized by bouts of Hyperthyroidism, even Thyroid Storm. The body thinks it's thyroid is the enemy and attacks it. Before completely burning out, the thyroid gland can go from Hypo to Hyper and back again. For women at least, the gland tends to finally burn out after menopause.

I have had Hashimoto's for about 22 years and have had periods of hyperthyroid activity as well as hypothyroid. I have been on medications for both at different times.

[kteague]

I know this is an old post , but I'm researching Hashimotos & other symptoms & this popped up. I was diagnossed with Moderate sleep apnea right about the time i ws diagnosed hypothyroid. CPAP & all. I've been studying how diet ( IE Gluten, sugar, dairy, ) & leaky gut play a Major role in autoimmune disorders. Seems like a plan. Taking a pill & using a CPAP & still feeling like crap isnt working 4 me.

Took me reading down to an old post of my own before realizing this is an old thread, but an interesting topic still. Looked around over on PubMed and it seems recent articles still don't report conclusive information. It's easy to believe our illnesses could be explained by their interrelationships. It's also easy to believe we can incidentally have various medical conditions with no relation. Just from a common sense approach, anything that crowds the airway can potentially contribute to OSA, and that would include an enlarged tongue and enlarged thyroid.
I'd venture to guess some day in the future your question will have definitive answers one way or the other. For now, we are left with treating each independently. Any time I read of somebody having OSA plus any other issue and still feeling like crap, my response comes from my own experience with this. Except in unusual cases, garden variety OSA treatment is pretty much black and white. It's diagnosed by numbers. Treatment can be assessed by data. This treatment will likely be the least elusive endeavor. Poor sleep and low oxygen can throw so many things off kilter. It's a good idea after establishing consistency with CPAP treatment to have other issues reassessed to see if doses of meds need adjusted. Nothing wrong with continuing to search for answers for those other things. We all want to feel the best we can. Hopefully you'll gain some useful info from others dealing with the same issues. Have you searched this forum for Hashimotos?

[fog.apnea]

old thread but thought add relevant info - http://www.thedoctorschannel.com/view/s ... se-of-osa/