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In the recent years, an association between sleep apnea and a  number of endocrine diseases has been established. The secretion of many hormones after falling asleep is considerably changed, compared to the period of wakefulness. In patients with endocrine disorders, abnormal hormonal secretion and its pathological consequences may contribute to sleep apnea. Sleep fragmentation and intermittent hypoxia arising in sleep apnea result in a decrease in insulin sensitivity, which contributes to the development of type 2 diabetes mellitus. The prevalence of sleep apnea increases in acromegaly, which may affect the risk of cardio-pulmonary complications. There is an association between sleep apnea and testosterone treatment in men, as well as in postmenopausal women. Sleep apnea in hypothyroidism is most frequently related to the development of hypothyroidism per se and can therefore be reversed with thyroid hormone replacement therapy. Timely detection and treatment of sleep apnea in patients with endocrine disorders can improve their survival prognosis and quality of life.

About the authors

I. V. Misnikova

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.

MD, PhD, Leading Research Fellow, Department of Therapeutic Endocrinology; Professor, Chair of Endocrinology, Postgraduate Training Faculty,

61/2 Shchepkina ul., Moscow, 129110

Russian Federation


  1. Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Rein J, Vela-Bueno A, Kales A. Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med. 2001;163(3 Pt 1):608–13. doi: 10.1164/ajrccm.163.3.9911064.
  2. Weitzman ED, Zimmerman JC, Czeisler CA, Ronda J. Cortisol secretion is inhibited during sleep in normal man. J Clin Endocrinol Metab. 1983;56(2):352–8. doi: 10.1210/jcem-56-2-352.
  3. Ковальзон ВМ. Основы сомнологии: физиология и нейрохимия цикла «бодрствование – сон». 3-е изд. М.: БИНОМ. Лаборатория знаний; 2014. 239 с.
  4. Einhorn D, Stewart DA, Erman MK, Gordon N, Philis-Tsimikas A, Casal E. Prevalence of sleep apnea in a population of adults with type 2 diabetes mellitus. Endocr Pract. 2007;13(4):355–62. doi: 10.4158/EP.13.4.355.
  5. Древаль АВ, Мисникова ИВ, Губкина ВА, Агальцов МВ, Федорова СИ. Оценка распространенности нарушений дыхания во сне у лиц с различными нарушениями углеводного обмена. Сахарный диабет. 2013;(1): 71–7.
  6. Яковлев АВ, Маянская СД, Вергазова АН, Плуталова ЛП, Мазина ПБ, Маянская НН, Яковлева НФ. Маркеры дисфункции жировой ткани у пациентов с ожирением и синдромом обструктивного апноэ сна. Казанский медицинский журнал. 2015;96(2):134–7.
  7. Louis M, Punjabi NM. Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers. J Appl Physiol (1985). 2009;106(5):1538–44. doi: 10.1152/japplphysiol.91523.2008.
  8. Stamatakis KA, Punjabi NM. Effects of sleep fragmentation on glucose metabolism in normal subjects. Chest. 2010;137(1):95–101. doi: 10.1378/chest.09-0791.
  9. Chrousos G, Vgontzas AN, Kritikou I. HPA axis and sleep [updated 2016 Jan 18]. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, Weickert MO, editors. Endotext [Internet]. South Dartmouth (MA):, Inc.; 2000. Available from:
  10. Kritikou I, Basta M, Vgontzas AN, Pejovic S, Fernandez-Mendoza J, Liao D, Bixler EO, Gaines J, Chrousos GP. Sleep apnoea and the hypothalamic-pituitary-adrenal axis in men and women: effects of continuous positive airway pressure. Eur Respir J. 2016;47(2):531–40. doi: 10.1183/13993003.00319-2015.
  11. Narkiewicz K, Somers VK. Sympathetic nerve activity in obstructive sleep apnoea. Acta Physiol Scand. 2003;177(3):385–90. doi: 10.1046/j.1365-201X.2003.01091.x.
  12. Young T, Peppard PE, Taheri S. Excess weight and sleep-disordered breathing. J Appl Physiol (1985). 2005;99(4):1592–9. doi: 10.1152/japplphysiol.00587.2005.
  13. Keskin A, Ünalacak M, Bilge U, Yildiz P, Güler S, Selçuk EB, Bilgin M. Effects of Sleep Disorders on Hemoglobin A1c Levels in Type 2 Diabetic Patients. Chin Med J (Engl). 2015;128(24):3292–7. doi: 10.4103/0366-6999.171415.
  14. Leong WB, Jadhakhan F, Taheri S, Chen YF, Adab P, Thomas GN. Effect of obstructive sleep apnoea on diabetic retinopathy and maculopathy: a systematic review and metaanalysis. Diabet Med. 2016;33(2):158–68. doi: 10.1111/dme.12817.
  15. Akkoyunlu ME, Ilhan MM, Bayram M, Taşan E, Yakar F, Ozçelik HK, Karakose F, Kart L. Does hormonal control obviate positive airway pressure therapy in acromegaly with sleep-disordered breathing? Respir Med. 2013;107(11):1803–9. doi: 10.1016/j.rmed.2013.08.043.
  16. Powlson AS, Gurnell M. Cardiovascular disease and sleep-disordered breathing in acromegaly. Neuroendocrinology. 2016;103(1):75–85. doi: 10.1159/000438903.
  17. Annamalai AK, Webb A, Kandasamy N, Elkhawad M, Moir S, Khan F, Maki-Petaja K, Gayton EL, Strey CH, O'Toole S, Ariyaratnam S, Halsall DJ, Chaudhry AN, Berman L, Scoffings DJ, Antoun NM, Dutka DP, Wilkinson IB, Shneerson JM, Pickard JD, Simpson HL, Gurnell M. A comprehensive study of clinical, biochemical, radiological, vascular, cardiac, and sleep parameters in an unselected cohort of patients with acromegaly undergoing presurgical somatostatin receptor ligand therapy. J Clin Endocrinol Metab. 2013;98(3):1040–50. doi: 10.1210/jc.2012-3072.
  18. Sakai A, Toga H, Tachibana O, Miwa T. Assessment of treatment effect for acromegaly with sleep disordered breathing. Nihon Jibiinkoka Gakkai Kaiho. 2013;116(5):612–8.
  19. Duarte FH, Jallad RS, Amaro AC, Drager LF, Lorenzi-Filho G, Bronstein MD. The impact of sleep apnea treatment on carbohydrate metabolism in patients with acromegaly. Pituitary. 2013;16(3):341–50. doi: 10.1007/s11102-012-0430-8.
  20. Peker Y, Svensson J, Hedner J, Grote L, Johannsson G. Sleep apnoea and quality of life in growth hormone (GH)-deficient adults before and after 6 months of GH replacement therapy. Clin Endocrinol (Oxf). 2006;65(1):98–105. doi: 10.1111/j.1365-2265.2006.02555.x.
  21. Liu PY, Yee BJ, Phillips CL, Grunstein RR. Sleep apnea and neuroendocrine function. Sleep Medicine Clinics. 2007;2(2):225–36.
  22. Hoyos CM, Killick R, Keenan DM, Baxter RC, Veldhuis JD, Liu PY. Continuous positive airway pressure increases pulsatile growth hormone secretion and circulating insulin-like growth factor-1 in a time-dependent manner in men with obstructive sleep apnea: a randomized sham-controlled study. Sleep. 2014;37(4):733–41. doi: 10.5665/sleep.3580.
  23. Liu PY, Yee B, Wishart SM, Jimenez M, Jung DG, Grunstein RR, Handelsman DJ. The short-term effects of high-dose testosterone on sleep, breathing, and function in older men. J Clin Endocrinol Metab. 2003;88(8):3605–13. doi: 10.1210/jc.2003-030236.
  24. Hoyos CM, Killick R, Yee BJ, Grunstein RR, Liu PY. Effects of testosterone therapy on sleep and breathing in obese men with severe obstructive sleep apnoea: a randomized placebo-controlled trial. Clin Endocrinol (Oxf). 2012;77(4):599–607. doi: 10.1111/j.1365-2265.2012.04413.x.
  25. Luboshitzky R, Lavie L, Shen-Orr Z, Herer P. Altered luteinizing hormone and testosterone secretion in middle-aged obese men with obstructive sleep apnea. Obes Res. 2005;13(4):780–6. doi: 10.1038/oby.2005.88.
  26. Celec P, Mucska I, Ostatníková D, Hodosy J. Testosterone and estradiol are not affected in male and female patients with obstructive sleep apnea treated with continuous positive airway pressure. J Endocrinol Invest. 2014;37(1):9–12. doi: 10.1007/s40618-013-0003-3.
  27. Galvan T, Camuso J, Sullivan K, Kim S, White D, Redline S, Joffe H. Association of estradiol with sleep apnea in depressed perimenopausal and postmenopausal women: a preliminary study. Menopause. 2016 Sep 19 [Epub ahead of print]. doi: 10.1097/GME.0000000000000737.
  28. Zhou XS, Rowley JA, Demirovic F, Diamond MP, Badr MS. Effect of testosterone on the apneic threshold in women during NREM sleep. J Appl Physiol (1985). 2003;94(1):101–7. doi: 10.1152/japplphysiol.00264.2002.
  29. Donato GB, Fuchs SC, Oppermann K, Bastos C, Spritzer PM. Association between menopause status and central adiposity measured at different cutoffs of waist circumference and waistto-hip ratio. Menopause. 2006;13(2):280–5. doi: 10.1097/
  30. Barbosa FR, Silva CM, Lima GA, Warszawski L, Domingues RC, Dominic M, Fontes R, Vieira Neto L, Gadelha MR. Prevalence of obstructive sleep apnea in patients with prolactinoma before and after treatment with dopamine agonists. Pituitary. 2014;17(5):441–9. doi: 10.1007/s11102-013-0524-y.
  31. Frieboes RM, Murck H, Stalla GK, Antonijevic IA, Steiger A. Enhanced slow wave sleep in patients with prolactinoma. J Clin Endocrinol Metab. 1998;83(8):2706–10. doi: 10.1210/jcem.83.8.5016.
  32. Jha A, Sharma SK, Tandon N, Lakshmy R, Kadhiravan T, Handa KK, Gupta R, Pandey RM, Chaturvedi PK. Thyroxine replacement therapy reverses sleep-disordered breathing in patients with primary hypothyroidism. Sleep Med. 2006;7(1):55–61. doi: 10.1016/j.sleep.2005.05.003.
  33. Araz O, Yilmazel Ucar E, Yalcin A, Pulur D, Acemoglu H, Tas H, Saglam L, Akgun M, Mirici A. The incidence and severity of pulmonary hypertension in obstructive sleep apnea with hypothyroidism. Med Sci Monit. 2013;19:883–7. doi: 10.12659/MSM.889619.
  34. Фадеева МИ, Савельева ЛВ, Фадеев ВВ. Cиндром обструктивного апноэ сна в практике врача-эндокринолога. Ожирение и метаболизм. 2010;(1):3–10.
  35. Bielicki P, Przybyłowski T, Kumor M, Barnaś M, Wiercioch M, Chazan R. Thyroid Hormone Levels and TSH Activity in Patients with Obstructive Sleep Apnea Syndrome. Adv Exp Med Biol. 2016;878:67–71. doi: 10.1007/5584_2015_180.
  36. Sawin CT, Castelli WP, Hershman JM, McNamara P, Bacharach P. The aging thyroid. Thyroid deficiency in the Framingham Study. Arch Intern Med. 1985;145(8):1386–8. doi: 10.1001/archinte.1985.00360080056006.
  37. Takeuchi S, Kitamura T, Ohbuchi T, Koizumi H, Takahashi R, Hohchi N, Suzuki H. Relationship between sleep apnea and thyroid function. Sleep Breath. 2015;19(1):85–9. doi: 10.1007/s11325-014-0966-0.
  38. Shipley JE, Schteingart DE, Tandon R, Starkman MN. Sleep architecture and sleep apnea in patients with Cushing's disease. Sleep. 1992;15(6):514–8.

Copyright (c) 2016 Misnikova I.V.

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