SLEEP BREATH I NG DISORDERS IN SOME ENDOCRINE D I SORDERS

Abstract

Sleep and circadian rhythmicity interact to regulate secretion of the majority of hormones (Van Cauter & Turek /995). Sleep also affect respiration so that some subjects are relatively healthy by day but may develop upper airway obstruction, either total or partial, during sleep (Calverley /995 "a") and as we all know, OSAS is the commonest "new disease" to be discovered for decades (Douglas 1995). Moreover, endocrine disease can exert profound effects on respiration (Rohatgi & Becker 1995). So it was logic to study the relation between OSAS and endocrine disorders. It was not surprising to conclude that the repetitive episodes of upper airway obstruction in OSAS, associated with hypoxemia and sleep fragmentation could affect the sleep-entrained or circadian rhythms of hormones (Gnmstein et al 1989). Also, it was not surprising to conclude that endocrine disorders, such as acromegaly and hypothyroidism could affect the upper airway function by mechanical obstruction and/or through central mechanisms (Rosenow et a/1994, Grunstein et al/994"a", Skatrud et a/1981 and Millman et a/1983). Besides, Diabetic patients and patients with OSAS present with similar clinical features, including obesity, daytime sleepiness and an increased occurence of cardiovascular morbidity and mortality (Stoohs et al 1996). There are few studies showed the association between OSA symptoms , such as DIS, OMS and EDS, and diabetes mellitus (Gislason & Almqvist 1987 and Sridhar & Madhu /994). Other reports found an association between OSA and IDDM and considered autonomic neuropathy as a link between the two diseases (Ress et al/981, Guilleminault eta/ 1981, Mondini & Guil/eminault 1985 and Neumann et al 1995). Others showed the association between OSA and NIDDM (Schiavi et al 1993 and Katsumata eta/ 1991). However, as far as we know, no available study about the relation between subjectively or objectively reported sleep related breathing disorders and diabetes mellitus