What proportion of acromegaly cases develop Obstructive Sleep Apnea (OSA)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: October 2, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Prevalence of Obstructive Sleep Apnea in Acromegaly

Approximately 75-80% of patients with acromegaly develop obstructive sleep apnea (OSA), making it one of the most common complications of this endocrine disorder. This high prevalence highlights the critical importance of screening all acromegaly patients for OSA at diagnosis.

Epidemiological Data on OSA in Acromegaly

  • The most recent evidence indicates that OSA affects 76.67% of newly diagnosed acromegaly patients, with moderate to severe OSA affecting 46% of these individuals 1
  • Another recent prospective study found a 74.1% prevalence of OSA in treatment-naïve acromegaly patients 2
  • A retrospective analysis of acromegaly patients who underwent polysomnography found that 78.1% had OSA (defined as AHI>5), with most (62.5%) having moderate-severe disease 3

Pathophysiological Mechanisms

  • OSA in acromegaly results primarily from craniofacial abnormalities and soft tissue overgrowth due to excess growth hormone 1, 4
  • Key anatomical changes contributing to OSA in acromegaly include:
    • Tongue base hypertrophy, which shows a statistically significant correlation with OSA severity (p<0.001) 1
    • Macroglossia (enlarged tongue), present in approximately 60% of acromegaly patients 5
    • Thickening of the laryngeal wall 3
    • Craniofacial bone and soft tissue changes that narrow the upper airway 1

Gender Differences

  • Women with acromegaly develop OSA at twice the rate of men, contrary to the general population where OSA is more common in males 1
  • Despite this difference in prevalence, the polysomnographic features and OSA severity are similar between genders in acromegaly patients 3

Risk Factors for OSA in Acromegaly

  • Age is a significant factor, with older acromegaly patients having higher risk of OSA (p=0.007) 3
  • A positive correlation exists between age and Apnea-Hypopnea Index (AHI) in acromegaly patients (r:0.426, p:0.015) 3
  • Interestingly, body mass index (BMI) does not appear to be a significant differentiator between acromegaly patients with and without OSA, unlike in the general population 3

Treatment Impact on OSA

  • Treatment of acromegaly significantly improves OSA in most patients 2
  • After 2.5 years of acromegaly treatment, 68.8% of patients with OSA at baseline experienced resolution of their sleep apnea 2
  • The greatest improvement in sleep parameters occurs during the first year of acromegaly treatment 2
  • Improvements in respiratory disturbance index (RDI), oxygen desaturation index (ODI), lowest oxygen saturation (LSaO2), and Epworth Sleepiness Scale (ESS) correlate with normalization of insulin-like growth factor 1 (IGF-1) levels 2

Clinical Implications

  • Given the extremely high prevalence of OSA in acromegaly (75-80% vs. approximately 5% in the general population), polysomnography should be performed in all newly diagnosed acromegaly patients 1, 3
  • Middle-aged acromegaly patients should be evaluated for OSA even without obvious obesity 3
  • Repeat polysomnography should be considered during acromegaly treatment to assess for improvement in OSA 2

References

2
Research

The Course of Obstructive Sleep Apnea Syndrome in Patients With Acromegaly During Treatment.

The Journal of clinical endocrinology and metabolism, 2020

3
Research

Evaluation of Acromegaly patients with sleep disturbance related symptoms.

Pakistan journal of medical sciences, 2021

4
Research

Acromegaly.

Handbook of clinical neurology, 2014

5
Research

Acromegaly: otolaryngic manifestations following pituitary surgery.

American journal of otolaryngology, 2015

Related Questions

What is the most appropriate investigation for a patient with acromegalic features, including a large head and hands, and lower limb pains, who has difficulty fitting through doors?
What happens to patients with Obstructive Sleep Apnea (OSA) and acromegaly after pituitary adenoma resection?
What is acromegaly?
What are the causes of elevated troponin levels?
What is the appropriate management for patients presenting with pulmonary nodules?
What is the treatment for an unspecified medical condition?
What is the recommended treatment for a patient with a group B strep (Streptococcus agalactiae) urinary tract infection (UTI) and a severe penicillin (PCN) allergy?
What is the recommended treatment for an acute diverticulitis flare?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question