Obesity and intermittent hypoxia increase tumor growth in a mouse model of sleep apnea

Sleep Apnea and 20-Year Follow-Up for All-Cause Mortality, Stroke, and Cancer Incidence and Mortality in the Busselton Health Study Cohort

“…[10][11][12] More recently severe sleep apnea has been linked with an increased risk of cancer. [13][14][15][16] Mild sleep apnea is far more common than severe sleep apnea but it has not yet been widely confi rmed that mild OSA contributes to increases in public health diseases in the way that severe OSA seems to. 17 Using 20-year follow-up data from the Busselton Sleep Cohort, we investigated whether sleep apnea was associated with all-cause mortality, cardiovascular disease, coronary heart disease, stroke, and cancer (both incidence and mortality), while controlling for the leading risk factors for who already belonged to the ongoing Busselton Health Study.…”

Sleep apnoea and cancer: current insights and future perspectives

“…The relative scientific youthfulness of OSA means that new action mechanisms and previously unknown associations with other diseases are now being increasingly discovered. One particular piece of news was sprung on the scientific community at recent international congresses, creating quite a stir: some studies in both animals [10][11][12] and humans [13][14][15], undertaken almost simultaneously, had found an association between OSA and cancer.…”

“…Any investigation of the relationship between OSA and cancer clearly has to take into account confounders, the most important probably being (apart from the well-known ones such as smoking, alcohol consumption and age) obesity and sleep duration. Obesity (and, by extension, metabolic syndrome) has proved to be a disease involving a low-intensity chronic inflammatory component, altering the balance of oxidative stress and modifying many hormones, growth factors and other mediators potentially contributing to the development and progression of cancer-related processes [12,28]. Moreover, obesity is capable of generating a certain degree of chronic hypoxia, especially at night, and this is also associated with a greater carcinogenic capacity [26].…”

Clinical physiology and sleep: insights from the European Respiratory Society Congress 2017

“…Studies suggest that IH in OSA may influence tumorigenesis (10). Animal studies indicate that the activation of a subunit of a heterodimeric transcription factor hypoxia-inducible factor 1 (HIF-1) and the vascular endothelial growth factor (VEGF) pathways in response to IH may promote the blood supply which supports tumor growth (11). In addition, tumor-associated macrophages may be altered by IH (or sleep fragmentation) to a tumor-promoting phenotype yielding more aggressive cancer behavior (8).…”