Abstract 66: Spectrum of sleep abnormalities in primary hypothyroidism

Background: The spectrum of sleep abnormalities in hypothyroidism includes daytime sleepiness, sleep apnoea, rapid eye movement sleep disorder, restless leg syndrome and periodic limb movement disorder. Aims and Objectives: To assess daytime somnolence, risk of sleep apnoea, quality of sleep, depression, and anxiety in subjects with primary hypothyroidism using Epworth Sleepiness Score (ESS), Berlin questionnaire, Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9) and Hamilton Anxiety Rating Scale (HAM-A). Results: This was a questionnaire-based cross-sectional study that included 55 subjects (females=44, males=11), both treatment naïve (N=41) and on treatment (N=14), who had TSH >4.5 mIU/L. The mean age was 37.09±12.49. Median TSH was 13.5 (IQR-19.781). The Median ESS score was 3/24 (IQR-7), three subjects had severe excessive daytime sleepiness. Seventeen individuals were predisposed to sleep apnoea as assessed by the Berlin Sleep questionnaire. Twenty subjects had a PSQI score of >5, indicating poor sleep quality. The median PHQ-9 score was 4/27 (IQR-7), one individual had severe, and one had moderately severe depression. The Median HAM-A score was 6/56 (IQR-11); two had severe anxiety. Conclusion: Individuals with hypothyroidism need to be screened for sleep abnormalities like sleep apnea, daytime somnolence, REM sleep disorders and neuropsychiatric manifestations like anxiety and depression.