Obstructive sleep apnoea (OSA) is common in acromegaly, and can persist even with good control of growth hormone/insulin-like growth factor-1 levels. Given that OSA is independently associated with metabolic and cardiovascular dysfunction, assessment is recommended in acromegaly.

This study by Powlson et al. investigated the performance of two commonly used OSA screening tests – the Epworth Sleepiness Scale (ESS) questionnaire and overnight pulse oxygen desaturation index (DI) – versus gold standard polysomnography, in 40 newly diagnosed, treatment-naïve patients with acromegaly.

They demonstrated that OSA (as defined by the apnoea–hypopnoea index; AHI) measured during gold standard polysomnography, was present in 79% of their cohort (mild n=12, moderate n=5, severe n=14). However, they observed significant discrepancies between OSA screening tests and polysomnography. In patients with OSA by AHI criteria, ESS (positive in only 35%, n=11) and DI (positive in 71%: mild n=11, moderate n=6, severe n=5) were shown to markedly underestimate its prevalence/severity in their cohort of patients with acromegaly.

Based on their findings, the authors advocate the use of polysomnography in all patients with newly diagnosed acromegaly to allow early identification/treatment of sleep disordered breathing.

Read the full article in Clinical Endocrinology 100 251–259 https://doi.org/10.1111/cen.14994