Sleep Disordered Breathing Is Highly Prevalent in Patients with Lung Cancer: Results of the Sleep Apnea in Lung Cancer Study

Cabezas, E.; Warnisher, María Teresa Pérez; Troncoso, María F.; Gómez, Teresa; Melchor, Rosario; Pinillos, Erwin Javier; Hachem, Abdul El; Gotera, Carolina; Rodríguez, Paula; Mahíllo‐Fernández, Ignacio; Martínez‐García, Miguel Ángel; González-Mangado,; Peces-Barba, Germán; Seijó, Luis

doi:10.1159/000492273

Cited by 42 publications

(28 citation statements)

References 30 publications

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“…Prospective studies examining associations between OSA and specific cancers are sparse. However, studies have reported associations between sleep disordered breathing and cutaneous melanoma [3,4], while another has reported a high prevalence of OSA in lung cancer patients [5].…”

Section: Introductionmentioning

confidence: 99%

Increased prevalence of obstructive sleep apnea in women diagnosed with endometrial or breast cancer

Madut¹,

Fuchsova²,

Man³

et al. 2021

PLoS ONE

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Background Epidemiological studies demonstrate associations between obstructive sleep apnea (OSA) and cancer incidence and mortality. The aim of this study was to measure OSA in women with breast (BC) or endometrial cancer (EC) and associations with clinico-pathological tumor variables. Methods and findings In a cross sectional study, women with BC (12 months) or EC (3 months) post-diagnosis were recruited from cancer clinics. We collected demographic, anthropometric data, cancer stage, grade, histopathology and history of cancer treatment and all subjects had in-laboratory polysomnography. Sleepiness was assessed with the Epworth Sleepiness Scale (ESS). We compared anthropometric and polysomnographic data between cancer groups (unpaired t-tests), and assessed relationships between cancer characteristics and OSA variables (Fishers exact test). There were no significant differences between average age (BC:59.6±8.7 years(n = 50); EC:60.3±7.7 years(n = 37)), or ESS score (BC:6.4±4.4; EC 6.8±4.7; mean±SD; all p>0.2), however, BMI was higher in EC (BC: 29.7±7.9kgm-2; EC: 34.2±8.0 kgm-2; p<0.05). BC had longer sleep latency (BC:31.8±32minutes; EC:19.3±17.9 minutes), less Stage 3 sleep (BC:20.0±5.2%; EC:23.6±8.2%) and more REM sleep (BC:21.1±6.9%; EC: 16.6±5.7%), all p<0.05. EC had lower average awake and asleep oxygen saturation levels (BC: 95.6±1.3%; EC: 94.6±1.9% [awake]: BC: 94.8±2.1%; EC: 93.3±2.4% [asleep]; both p<0.05). Apnea-Hypopnea Index (AHI) (BC: 21.2(7.3–36.9) events/hr; EC: 15.7 (10–33.5) events/hour (median (interquartile range)) was not different p = 0.7), however, 58% and 57% of women with BC and EC respectively, had an AHI>15 events/hour. In this small sample size group, no significant associations (all p>0.1) were detected between OSA metrics and clinico-pathological tumor variables. Conclusion In postmenopausal women with breast or endometrial cancer there is high prevalence of OSA, with no association with specific tumor characteristics detected. Recognition of the high prevalence of OSA in women with cancer is important to recognise as it may impact on surgical risk and quality of life.

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Section: Introductionmentioning

confidence: 99%

Increased prevalence of obstructive sleep apnea in women diagnosed with endometrial or breast cancer

Madut¹,

Fuchsova²,

Man³

et al. 2021

PLoS ONE

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“…But it could not determine whether OSA affects the prevalence of lung cancer [12]. Another study performed in Spain reported that the prevalence of OSA was 80% in consecutive patients with newly diagnosed lung cancer [9]. A cross-sectional study including 302 patients for investigating relationship between OSA and lung cancer discovered that AHI and nocturnal hypoxemia did increase the incidence of lung cancer, especially moderate and severe OSA [7].…”

Section: Discussionmentioning

confidence: 99%

The Association Between Obstructive Sleep Apnea and Lung Nodule, Carcinoembryonic Antigen

Zeng

Chen

Zhao

et al. 2021

Preprint

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Purpose: The association between obstructive sleep apnea (OSA) and cancer risks gaining more and more attention. Data on the association between OSA and lung cancer risk are limited. This study is to investigate whether a link exists between Low-dose computed tomography (LDCT) scanning of the chest findings, carcinoembryonic antigen (CEA) and OSA in patients suspected of OSA.Methods: The cross-sectional study included patients aged 18 years or older who underwent continuous nocturnal polysomnography at our sleep center between February 2019 and November 2020. All subjects underwent chest LDCT and CEA. Patients with an apnea-hypopnea index(AHI) of ≥15/h were classified as clinically significant OSA group, whereas patients with an AHI ＜15/h were classified as control group.Results: A total of 277 patients were enrolled in the study. 176 patients were categorized into the OSA group, while 101 patients were categorized into the control group. There is no relationship between any OSA-related parameter and presence of lung nodule or presence of ≥6mm lung nodule in the binary logistic regression analysis. OSA group demonstrated a significant higher value of CEA than control group. Stepwise multiple linear regression analysis showed that lowest O2 saturation(β=-0.256, p＜0.001), smoking status (β=0.156, p=0.007) and age (β=0.153, p=0.008) were independent predictors of elevated CEA. Conclusion: In a group of patients suspected of OSA, we confirmed an independent correlation between nocturnal hypoxia and elevated CEA levels. OSA was not related with presence of pulmonary nodule or≥6 mm pulmonary nodule in LDCT.

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“…This hypothesis is strengthened by epidemiological observations indicating a considerably highly prevalence of OSA in cancer populations. For example, 50% of patients with lung cancer were also diagnosed with moderate-to-severe OSA [44,45]. Some studies have also suggested that sleep disordered breathing may be associated with cancer aggressiveness and worse prognosis [37,46,47].…”

Section: Discussionmentioning

confidence: 99%

Telomere Length and Risk of Major Adverse Cardiac Events and Cancer in Obstructive Sleep Apnea Patients

Polonis

Sompalli

Becari

et al. 2019

Cells

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Telomere length (TL) is associated with cardiovascular disease (CVD) and cancer. Obstructive sleep apnea (OSA) is also linked to higher risk of CVD and cancer, and to TL. We investigated the association between TL and risk of major adverse cardiac events (MACE) and cancer in OSA patients. We studied 210 individuals undergoing sleep-related studies between 2000 and 2007. Baseline characteristics and follow-up data (available in 164 subjects) were obtained from clinic records. Incidence rates were calculated for the entire group and by OSA status. Hazard ratios were calculated to estimate effects of OSA and TL on risk of MACE and cancer. In total, 32 individuals (20%) developed MACE and/or cancer during 12.7-year follow-up. The OSA group had a higher likelihood of cancer (16.0 vs. 4.9 events per 1000 person-years, P = 0.044) but no clear evidence of an elevated incidence of MACE (10.8 vs. 4.8 events per 1000 person-years, P = 0.293) compared to the non-OSA group. There was no association between TL and MACE- (HR = 1.01, 95% CI 0.78–1.28), or cancer-risk (HR = 1.18, 95% CI 0.96–1.43). Our study warrants further investigation of any modulating effect of OSA on TL and the risk of MACE and cancer.

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Sleep Disordered Breathing Is Highly Prevalent in Patients with Lung Cancer: Results of the Sleep Apnea in Lung Cancer Study

Cited by 42 publications

References 30 publications

Increased prevalence of obstructive sleep apnea in women diagnosed with endometrial or breast cancer

Increased prevalence of obstructive sleep apnea in women diagnosed with endometrial or breast cancer

The Association Between Obstructive Sleep Apnea and Lung Nodule, Carcinoembryonic Antigen

Telomere Length and Risk of Major Adverse Cardiac Events and Cancer in Obstructive Sleep Apnea Patients

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