Effects of Total Thyroidectomy and Radioactive Iodine Therapy for Thyroid Cancer Patients on Sleep Apnea and Snoring

Seung-Hyun Oh; Cheol-Seung Kim; Mal-Rye Choi; Eun-Hae Choi; Hyeong-Wook Kim; Joo-Hee Hahn; Tae-Hyung Kim; Byung-Jo Kim; Young-Sahm Park; Hun-Jeong Eun

doi:10.4306/jknpa.2015.54.4.495

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Oh, Kim, Choi, Choi, Kim, Hahn, Kim, Kim, Park, and Eun: Effects of Total Thyroidectomy and Radioactive Iodine Therapy for Thyroid Cancer Patients on Sleep Apnea and Snoring

Original Article

Journal of Korean Neuropsychiatric Association 2015; 54(4): 495-505.

Published online: 30 November 2015

DOI: https://doi.org/10.4306/jknpa.2015.54.4.495

Effects of Total Thyroidectomy and Radioactive Iodine Therapy for Thyroid Cancer Patients on Sleep Apnea and Snoring

Seung-Hyun Oh, MD¹, Cheol-Seung Kim, MD, PhD^2,³, Mal-Rye Choi, MD, PhD¹, Eun-Hae Choi, MD^2,³, Hyeong-Wook Kim, MD^1,⁴, Joo-Hee Hahn, MD^5,⁶, Tae-Hyung Kim, MD, PhD¹, Byung-Jo Kim, MD, PhD^1,⁴, Young-Sahm Park, MD^2,³, Hun-Jeong Eun, MD, PhD, DBA^1,⁴

¹Department of Neuropsychiatry, Presbyterian Medical Center-Jesus Hospital, Jeonju, Korea.

²Department of General Surgery, Presbyterian Medical Center-Jesus Hospital, Jeonju, Korea.

³Department of General Surgery, Seonam University College of Medicine, Jeonju, Korea.

⁴Department of Neuropsychiatry, Seonam University College of Medicine, Jeonju, Korea.

⁵Department of Otolaryngology, Presbyterian Medical Center-Jesus Hospital, Jeonju, Korea.

⁶Department of Otolaryngology, Seonam University College of Medicine, Jeonju, Korea.

Address for correspondence: Hun-Jeong Eun, MD, PhD, DBA. Department of Neuropsychiatry, Presbyterian Medical Center-Jesus Hospital, Seonam University College of Medicine, 365 Seowon-ro, Wansan-gu, Jeonju 54987, Korea. Tel +82-63-230-1551, Fax +82-63-230-1568, pmcnp96@gmail.com

Received 30 June 2015 Revised 4 August 2015 Accepted 31 August 2015

Abstract

Objectives

Some paper claim thyroidectomy decreases snoring and sleep apnea symptoms and the opposite. The aim of this study is to evaluate and compare the effects of sleep apnea and snoring by total thyroidectomy and radioactive iodine (RI) therapy.

Methods

A total of 88 patients who underwent total thyroidectomy and RI therapy for thyroid cancer in the outpatient clinic of the department of surgery of a general hospital were recruited. Interviewers completed their demographic data, past medical history, and data on total thyroidectomy and sleep apnea with snoring, and also preoperative and postoperative Pittsburgh Sleep Quality Index (PSQI), preoperative and postoperative Epworth Sleepiness Scale (ESS), preoperative and postoperative Snoring Index (SI), preoperative and postoperative global life satisfaction (index of well-being) scale, and postoperative Beck Depression Inventory.

Results

The Wilcoxon Signed Ranks Test showed PSQI preoperative-postoperative p=0.750, ESS preoperative-postoperative p=0.000, SI preoperative-postoperative p=0.034, life satisfaction preoperative-postoperative p=0.216 (based on negative ranks).

Conclusion

The above results indicate that snoring and daytime sleepiness increased after total thyroidectomy and RI therapy, suggesting that the patency of upper airway (UA) was reduced or the collapsibility of the UA increased after total thyroidectomy and RI therapy. That is, the above results indicate that sleep apnea and snoring were aggravated after total thyroidectomy and RI therapy.

Keywords: Total thyroidectomy, Radioactive iodine, Sleep apnea, Thyroid cancer, Upper airway, Snoring

Figures and Tables

Table 1

Demographic data

^* : p<0.05, ^† : χ² test. SD : Standard deviation

Table 2

Ranks of variables

^a : PSQI-postop<PSQI-preop18, ^b : PSQI-postop>PSQI-preop, ^c : PSQI-postop=PSQI-preop, ^d : ESS-postop<ESS-preop, ^e : ESS-postop>ESSpreop, ^f : ESS-postop=ESS-preop, ^g : SI-postop<SI-preop, ^h : SI-postop>SI-preop, ⁱ : SI-postop=SI-preop, ^j : Life sat-postop<Life sat-preop, ^k : Life sat-postop>Life sat-preop, ^l : Life sat-postop=Life sat-preop. PSQI : Pittsburgh Sleep Quality Index, ESS : Epworth Sleepiness Scale, SI : Snoring Index, postop : Postoperative, preop : Preoperative

Table 3

Test statistics of Wilcoxon signed ranks test

^* : p<0.05, ^† : Based on negative ranks. PSQI : Pittsburgh Sleep Quality Index, ESS : Epworth Sleepiness Scale, SI : Snoring Index, preop-postop : Preoperative-postoperative

Table 4

Mean data of variables on total thyroidectomy and radioactive iodine therapy (n=88)

ESS : Epworth Sleepiness Scale, SI : Snoring Index, PSQI : Pittsburgh Sleep Quality Index, Life sat : Life satisfaction, preop : Preoperative, postop : Postoperative, SD : Standard deviation

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

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