The impact of thyroidectomy on obstructive sleep apnea: a systematic review and meta-analysis

Razan Masarwy, Liyona Kampel, Omer J. Ungar, Anton Warshavsky, Gilad Horowitz, Eyal Rosenzweig, Riva Tauman, Nidal Muhanna*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Purpose: Various thyroid pathologies are speculated to contribute to obstructive sleep apnea (OSA). The underlying mechanisms of the intricate relationship between OSA and thyroid structure and function, and whether thyroidectomy can alleviate OSA symptoms remain unclear. An assessment of the impact of thyroidectomy on OSA is warranted. Methods: A systematic review of four electronic databases (PubMed (Medline), Embase, the Cochrane library, and was performed up to February 2022. The primary outcomes were preoperative and postoperative Apnea/Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Berlin questionnaire scores, and continuous positive airway pressure (CPAP) use. A meta-analysis of continuous measures and odd ratios was conducted. Small-scale studies underwent a qualitative meta-analysis. Results: Six cohort studies on 221 OSA patients who underwent thyroidectomies were included. The results showed that thyroidectomy was associated with significant reduction in postoperative AHI (Mean difference [MD], −6.39, 95% CI, −12.46 to −0.32), however, no significant association was found with CPAP withdrawal (Odd ratio [OR], 0.38, 95% CI, 0.12–1.18). Neither the Berlin questionnaire score (OR, 0.19, 95% CI, 0.03–1.17) nor the ESS improved postoperatively (MD, −1.04, 95% CI, −6.37 to 4.29). Conclusion: This meta-analysis provides a quantitative estimate for the effect of the thyroidectomy on OSA and suggests that thyroidectomy is associated with limited clinical improvement of polysomnographic measures. Future large-scale, well-designed prospective studies are necessary to validate these findings and to refine accordingly the preoperative assessment of both medical conditions individually and in combination.

Original languageEnglish
Pages (from-to)5801-5811
Number of pages11
JournalEuropean Archives of Oto-Rhino-Laryngology
Issue number12
StatePublished - Dec 2022


  • Goiter
  • Obstructive sleep apnea
  • Polysomnography
  • Sleep-disordered breathing
  • Thyroidectomy


Dive into the research topics of 'The impact of thyroidectomy on obstructive sleep apnea: a systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this