OSA in patients with head and neck cancer is associated with cancer size and oncologic outcome

Huppertz, Tilman; Horstmann, Vera; Scharnow, Charlotte; Ruckes, Christian; Bahr, Katharina; Matthias, Christoph; Gouveris, Haralampos

doi:10.1007/s00405-020-06355-3

Cited by 22 publications

(24 citation statements)

References 31 publications

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“…Li and colleagues described OSA severity as a risk factor that contributed to short overall survival in patients with lung cancer [6]. A study by Huppertz and colleagues demonstrated a significant association between recurrent disease or cancer-related mortality and higher AHI in patients with head and neck squamous cell carcinoma (HNSCC) [16].…”

Section: Obstructive Sleep Apnea and Cancer Riskmentioning

confidence: 99%

“…Regarding HNSCC, different authors reported coexisting OSA [14][15][16][17][18][19][40][41][42][43][44][45]. Worldwide, over 500,000 new cases of HNSCC are reported annually, being the seventh most common type of cancer [20,46].…”

Section: Obstructive Sleep Apnea Might Be a Relevant Comorbidity Of Head And Neck Cancermentioning

confidence: 99%

“…Patients with an AHI ≥20 had a tendency to have increased postoperative complications [18]. Huppertz and colleagues showed an OSA prevalence of 90% in patients with HNSCC pre-treatment, increasing to 94% post-treatment [16]. Accordingly, Quyang and colleagues showed that OSA prevalence increased from 50% to 82.5% when laryngeal cancer was treated with laryngeal function preservation surgery [44].…”

Section: Obstructive Sleep Apnea Might Be a Relevant Comorbidity Of Head And Neck Cancermentioning

confidence: 99%

“…There is evidence of increased cancer mortality in patients with OSA during follow-up compared to general population samples [12,13]. Different authors reported coexisting OSA in patients with head and neck cancer, especially after therapy [14][15][16][17][18][19]. In addition, recent evidence suggests very high OSA prevalence in patients with head and neck cancer even pre-treatment [16].…”

Section: Introductionmentioning

confidence: 99%

“…Different authors reported coexisting OSA in patients with head and neck cancer, especially after therapy [14][15][16][17][18][19]. In addition, recent evidence suggests very high OSA prevalence in patients with head and neck cancer even pre-treatment [16]. Head and neck cancer ranks among the top ten most common types of cancer worldwide with a severe impact on quality of life and elevated mortality in affected individuals [20,21].…”

Section: Introductionmentioning

confidence: 99%

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Obstructive Sleep Apnea in Patients with Head and Neck Cancer—More than Just a Comorbidity?

et al. 2021

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Obstructive sleep apnea is the most common type of sleep-disordered breathing with growing prevalence. Its presence has been associated with poor quality of life and serious comorbidities. There is increasing evidence for coexisting obstructive sleep apnea in patients suffering from head and neck cancer, a condition that ranks among the top ten most common types of cancer worldwide. Routinely, patients with head and neck cancer are treated with surgery, radiation therapy, chemotherapy, immunotherapy or a combination of these, all possibly interfering with the anatomy of the oral cavity, pharynx or larynx. Thus, cancer treatment might worsen already existing obstructive sleep apnea or trigger its occurrence. Hypoxia, the hallmark feature of obstructive sleep apnea, has an impact on cancer biology and its cure. Early diagnosis and sufficient treatment of coexisting obstructive sleep apnea in patients with head and neck cancer may improve quality of life and could also potentially improve oncological outcomes.

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Section: Obstructive Sleep Apnea and Cancer Riskmentioning

confidence: 99%

Section: Obstructive Sleep Apnea Might Be a Relevant Comorbidity Of Head And Neck Cancermentioning

confidence: 99%

Section: Obstructive Sleep Apnea Might Be a Relevant Comorbidity Of Head And Neck Cancermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Obstructive Sleep Apnea in Patients with Head and Neck Cancer—More than Just a Comorbidity?

et al. 2021

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Treatment of obstructive sleep apnea with CPAP improves daytime sleepiness and fatigue in cancer patients

Ganjaei,

Wong,

Strauss

et al. 2024

Cancer Medicine

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BackgroundFatigue and sleep disorders are prevalent in cancer patients. Obstructive sleep apnea (OSA) commonly causes excessive daytime sleepiness (EDS) and fatigue. We hypothesize that treating cancer patients with OSA using positive airway pressure (PAP) will improve EDS and fatigue.MethodsA retrospective chart review of sleep clinic visits of cancer patients with newly diagnosed OSA was performed. Epworth Sleepiness Scale (ESS) and fatigue reported at baseline and within 6 months of starting PAP therapy were compared between PAP‐adherent and PAP‐non‐adherent patients.Results65 cancer patients with OSA and ESS >10 were recommended PAP therapy, including 45 patients with fatigue. 29 patients pursued PAP therapy with 79% (n = 23) adherent at follow‐up. The median baseline apnea hypopnea index (AHI) for OSA was 24.0 (interquartile range [IQR] 14.3, 32.3) and 23.8 (IQR 10.1, 42.8) events/hour among PAP‐adherent and PAP‐non‐adherent patients, respectively (p = 0.90). Median baseline ESS was 14.0 (IQR 12.0, 17.0) among adherent and 17.0 (IQR 11.0, 17.3) among non‐adherent patients (p = 0.73). The median ESS at follow‐up of the adherent and non‐adherent groups was 8.0 (IQR 6.0, 10.0) and 11.0 (IQR 8.0, 15.8), respectively (p = 0.08). Median ESS change was −5.0 (IQR −7.0, −4.0) in PAP adherent patients and −2.5 (IQR −5.25, −1.50) in PAP‐non‐adherent patients (p = 0.07). When the groups are examined separately, the median change in the PAP‐adherent group was highly significant (p = 0.001), while the ESS median change in the PAP‐non‐adherent group was considerably less (p = 0.04). 17 out of the 21 PAP‐adherent patients reporting fatigue at baseline indicated improvement at follow‐up.ConclusionsPAP therapy for OSA in cancer patients improves EDS and fatigue. Larger studies are necessary to evaluate the efficacy of PAP in improving fatigue in this population.

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Prevalence of obstructive sleep apnea after treatment for advanced T-stage head and neck cancer

Karsten,

Rijken,

Toprak

et al. 2024

Eur Arch Otorhinolaryngol

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Purpose Treatment of head and neck cancer (HNC) may lead to obstructive sleep apnea (OSA), but conclusive results on the prevalence of OSA are lacking. The objective of this study is to investigate the prevalence of OSA in a cohort of patients treated for advanced T-stage HNC. Methods A cross-sectional study was conducted in two tertiary cancer care centers including patients at least 1 year after treatment with curative intent with surgery and/or (chemo)radiotherapy ((C)RT) for advanced T-staged (T3-4) cancer of the oral cavity, oropharynx, hypopharynx, or larynx. A polysomnography (PSG) was performed in all participants. OSA was defined as an apnea–hypopnea index (AHI) of 15 events/h or higher or an AHI of 5 events/h and higher with OSA related symptoms, such as sleeping problems, daytime dysfunction and/or cardiac/metabolic comorbidities collected through file review and questionnaires. Results Of the 67 participants, 48 (72%, 95% CI 59–82%) were diagnosed with OSA. Possible risk factors are male gender, higher BMI, greater neck circumference, more nicotine pack years, cardiometabolic comorbidities, use of medication with sleepiness as side effect, present tonsils, lower T-stage (T3 vs. T4 stage), higher AJCC stage and a HPV-negative tumor. Conclusion In this population of advanced T-stage HNC patients, the prevalence of OSA was 72%, which is considerably higher than in the general population (2–50%). Given the high prevalence, screening of this entire subgroup for OSA may be indicated. Future studies to identify high risk factors and develop an OSA screening protocol are needed.

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OSA in patients with head and neck cancer is associated with cancer size and oncologic outcome

Cited by 22 publications

References 31 publications

Obstructive Sleep Apnea in Patients with Head and Neck Cancer—More than Just a Comorbidity?

Obstructive Sleep Apnea in Patients with Head and Neck Cancer—More than Just a Comorbidity?

Treatment of obstructive sleep apnea with CPAP improves daytime sleepiness and fatigue in cancer patients

Prevalence of obstructive sleep apnea after treatment for advanced T-stage head and neck cancer

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