Impact of moderate-to-severe obstructive sleep apnea on aggressive clinicopathological features of papillary thyroid carcinoma

Recent advances in the study of the correlation between obstructive sleep apnea and thyroid-disorders

PURPOSE

Epidemiological studies have revealed significant associations between obstructive sleep apnea (OSA) and thyroid disorders, but discrepancies and contradictory results remain in some studies. Given the limited research currently available on this topic, this article aims to review the relationship between OSA and thyroid diseases.

METHODS

PubMed, Embase, Web of Science, and The Cochrane Library were searched for the most recent literature on the correlation, mechanism, and treatment of OSA with various thyroid disorders for the last 10 years up to December 5, 2024.

RESULTS

There is a bidirectional association between OSA and thyroid disease. On the one hand, OSA not only increases the incidence of thyroid disorders, but also aggravates the severity of thyroid disorders, thereby negatively affecting treatment outcomes and prognosis; on the other hand, certain thyroid disorders may in turn promote the development of OSA.

CONCLUSION

OSA is closely associated with the development of thyroid disease, but the specific mechanism is not clear. Effective treatments for thyroid disease combined with OSA need to be further investigated.

Causal Associations of Obstructive Sleep Apnea With Cancer Risk: A Mendelian Randomization Study

BACKGROUND

Observational studies have associated obstructive sleep apnea (OSA) with a higher risk of various cancers; however, causal relationships have not yet been definitively established.

METHODS

Our study evaluated the causal impact of OSA on the risk of developing 22 different types of cancer using univariable and multivariable Mendelian randomization (MR). OSA-associated genetic instruments were obtained from the FinnGen study, which incorporates 38,998 OSA individuals and 336,659 non-OSA individuals from European descent. Summary-level data for 22 site-specific cancers were estimated from large genetic consortia and UK Biobank. We used inverse-variance weighting (IVW) as the primary analysis, along with several sensitivity analyses.

RESULTS

Univariable MR analyses indicated a causal relationship of genetic susceptibility to OSA on an increased risk of Barrett's esophagus (BE) and esophageal cancer (odds ratio [OR] = 1.32, 95% confidence interval [CI] = 1.07-1.62, p = 0.01), endometrial cancer (OR = 1.36, 95% CI = 1.16-1.60, p = 2.26E-04), and its endometrioid subtype (OR = 1.28, 95% CI = 1.04-1.59, p = 0.02). Multivariable MR, accounting for possible confounders like drinking and smoking, confirmed the causal relationships of OSA on BE and esophageal cancer, and endometrial cancer.

CONCLUSIONS

This study provided evidence regarding causal associations of OSA with higher risk of BE and esophageal cancer, and endometrial cancer.

Sleep quality of patients with papillary thyroid carcinoma: a prospective longitudinal study with 5-year follow-up

We evaluated the pre- and postoperative sleep quality of patients with newly diagnosed papillary thyroid carcinoma (PTC) who underwent thyroid surgery, and investigated the factors associated with persistent poor sleep quality. The Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale, and Stanford sleepiness scale were used to estimate sleep quality and daytime sleepiness. Face-to-face surveys were conducted preoperatively, and 1, 4, and 10 months after thyroid surgery. The PSQI was administered during a telephone interview about after 5 years after surgery. Forty-six patients (mean age 47.3 ± 10.1 years) with PTC (11 males, 35 females) were included in this study. Twenty-one participants underwent lobectomy and 25 underwent total thyroidectomy. Preoperatively, 35 (76.1%) patients showed poor sleep quality. PSQI scores at postoperative 1, 4, and 10 months were significantly lower than preoperative scores (p < 0.001). Postoperative 5-year PSQI scores decreased significantly compared to the preoperative scores (p < 0.001). Patients newly diagnosed with PTC suffered from sleep disturbance before and after surgery for at least 10 months, recovering to a comparable rate of sleep disturbance with the general population by 5 years after surgery. Higher preoperative PSQI score was at risk for prolonged poor sleep quality in patients with PTC.