Polygraphic Study of Periodic Breathing and Hypersomnolence in a Patient with Severe Hypothyroidism

Abstract

A 67 yr old woman with primary hypothyroidism, who also had Pickwickian syndrome, was studied electrophysiologically. A polygraphic study with simultaneous recordings of electroencephalography, actograms of the abdominal wall, the mentum and the anterior neck and electromyogram of the intercostal muscles revealed a cyclic appearance of apnea in the sleep phase and gasping preceding arousal, which, together with macroglossia and sleep in the sitting position, suggested a cyclic obstruction of the upper airway. The obstruction appeared responsible for both alveolar hypoventilation and disturbance of consciousness.