|Authors||Reiher AE, Mazeh H, Schaefer S, Chen H, Sippel RS|
|Publish Date||2012 May 29|
Background: Patients with goiters often complain of compressive symptoms, which may contribute to symptoms of obstructive sleep apnea. However, the impact of thyroid enlargement on these symptoms is not clear. Therefore we sought to evaluate whether symptoms of sleep apnea resolved after thyroidectomy by using a validated questionnaire. Methods: The Berlin questionnaire, a validated sleep apnea assessment tool, was provided to patients at a single academic institution before and after thyroidectomy. Patients who admitted to symptoms of snoring were asked to complete the questionnaire before and 8 weeks after surgery to assess for improvement in symptoms. The questionnaire uses 3 categories of questions to determine risk of sleep apnea. Two symptom categories must be positive for a patient to be considered “high risk” for sleep apnea. Results: Forty-five patients completed both pre and post-op questionnaires. The average age of patients completing the questionnaire was 53±2, and 78% of patients were female. Average BMI was 33.3±1.4 kg/m2. Based on their pre-operative questionnaire score 71% of patients were considered to be high risk for obstructive sleep apnea, this decreased to 51% after surgery (p=0.002). Overall scores significantly improved after surgery (mean 2.0 vs. 1.6, p<0.0001). Specifically, patients noted a significant decrease in snoring frequency after surgery (p=0.002), as well as a significant decrease in whether or not their snoring bothered others (p=0.004). The frequency of nodding off during the day also significantly decreased after surgery (p=0.02). Among patients with ≥25% improvement compared with those with <25% improvement in scores, the only significant difference found was a higher pre-op TSH among patients with <25% improvement (p=0.03). No significant difference was found between age, gender, presence of compressive symptoms, gland weight at resection, presence of thyroiditis, or the largest dimension of the gland at resection. Conclusions: Thyroid surgery appears to significantly improve symptoms of obstructive sleep apnea in patients who screened positive for symptoms prior to surgery. Evaluation of patients with obstructive sleep apnea should include evaluation of thyroid disease, as symptoms of sleep apnea may improve with thyroidectomy.