Can subclinical hypothyroidism worsen OSA in women?

Question

Hello doctor,

I am a 41-year-old female with a BMI of 33, and I have been snoring and waking up with headaches. I had a sleep study that showed moderate OSA (AHI 18). My TSH is 4.6 mIU/L, and free T4 is 0.9 ng/dL. Could subclinical hypothyroidism be worsening OSA in women? Is there a link between estrogen loss and airway muscle tone?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

According to your medical history and complaint regarding snoring, as you mentioned, your BMI (body mass index) is 33, which means you are obese. In obese individuals, during sleep, the muscles at the back of the airway relax, and the upper airway partially or completely collapses, which leads to obstruction in breathing, restricts airflow, and causes snoring. Obstruction in the airway decreases oxygen levels in the blood, which leads to headaches and waking up at night during sleep.

Your TSH (thyroid-stimulating hormone) is slightly increased, and free T4 (thyroxine) levels are in the normal range. Yes, subclinical hypothyroidism may worsen OSA (obstructive sleep apnea), but in your case, there are fewer chances of subclinical hypothyroidism.

When estrogen increases in the body, it promotes ATP (adenosine triphosphate) beta-oxidation respiration, which leads to an increase in muscle mass and the regeneration of satellite cells. When estrogen decreases in the body, it causes atrophy and sarcopenia, which leads to decreased muscle tone. As age increases, estrogen levels decrease, and this decline in estrogen reduces airway muscle tone, making an individual more prone to snoring.

So, do not worry, at the age of 41, you can still control your BMI and body weight. Please exercise regularly and avoid fatty foods and beverages. This will help in decreasing your snoring and waking up at night.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.