In patients with acromegaly obstruction of the upper airway may develop due to enlargement of the tongue and thickening of the tissues of the larynx. The sleep apnea syndrome may develop in patients with upper airway obstruction from other causes. We studied a somnolent patient with acromegaly in whom we documented the sleep apnea syndrome. Endoscopy, while the patient was sleeping, revealed that periodic obstruction during sleep occurred because the large tongue bulged into the pharynx and obliterated the pharyngeal airway. Tracheostomy was followed by the disappearance of the somnolence. The upper airway obstruction in acromegaly may result in severe hypoxemia and disruption of normal sleep.
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