Two Cases of Severe Obstructive Sleep Apnea Induced by Neck Radiotherapy Treated with an Oral Device

Piccin, Ottavio; Sorrenti, Giovanni; Milano, Francesca

doi:10.1007/s12663-015-0853-7

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…In addition to edema of the upper airway after CRT, xerostomia and dysphagia are known to have adverse effects (39,40). Piccin et al reported that the site of upper airway obstruction after treatment with HNC was the level of the larynx (15). In our study, the MRI findings showed that the width of the epiglottis tended to increase, although not significantly.…”

Section: Discussionsupporting

confidence: 37%

“…Some authors have previously reported a relatively high prevalence of OSA in patients following RT for HNC, but little is known about the impact of such treatment on sleep disorders and their underlying mechanisms (13,14). To the best of our knowledge, most relevant studies to date have assessed only post-treatment OSA incidence (7,13,(15)(16)(17)(18). Furthermore, whether there is an association between RT-induced changes in pharyngeal morphology and OSA prevalence remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Impact of radiotherapy for head and neck cancer on obstructive sleep apnea: a prospective study

Inoshita¹,

Sata²,

Ohba³

et al. 2022

Ann Palliat Med

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Background: In recent years, a relatively high prevalence of obstructive sleep apnea (OSA) in patients following radiotherapy (RT) for head and neck cancer (HNC) has been reported; however, little is known regarding the impact of RT on sleep disorders and the underlying mechanisms. This aim of this study was to elucidate the pathogenesis of OSA by comparing the clinical and sleep test parameters and magnetic resonance imaging (MRI) findings before and after HNC treatment with radiation.Methods: This prospective study included patients scheduled for RT with or without chemotherapy or bioradiotherapy for HNC. Patients diagnosed with HNC between May 2017 and August 2020 were consecutively recruited. The results of the sleep tests were analyzed both before and after treatment. The clinical characteristics of the patients and cephalometric and MRI parameters were also measured.Results: First, a total of 32 patients (64.8±11.8 years old; BMI, 22.7±3.6 kg/m 2 ) underwent pre-treatment sleep tests. The prevalence of OSA [apnea hypopnea index (AHI) ≥5] in these patients was 81.3% (26 patients) before treatment, and the mean AHI was 20.8±19.0 events/hr. Next, 21 patients performed a sleep test both before and after treatment. Regarding subjective symptoms, there were no significant differences in the Epworth Sleepiness Scale (ESS) (P=0.142) or Pittsburgh Sleep Quality Index (PSQI) (P=0.935) after treatment; however, the BMI and neck circumference significantly decreased after treatment (P<0.0001 and P=0.0001, respectively). The incidence of OSA in these patients was 81.0% (17 patients) before treatment and 85.7% (19 patients) after treatment (P=1.0). Overall, the AHI was not significantly different, changing only from 14.5 to 14.9 after treatment (P=0.147). The MRI parameters showed that the retroglossal pharyngeal area increased significantly after treatment (P=0.007).Conclusions: This study found that the prevalence of OSA before and after RT for HNC was higher than that in the normal population, despite a significant decrease in BMI and increase in the retroglossal pharyngeal area after treatment. We suggest that physicians who manage patients with HNC should consider the occurrence of OSA before and after treatment.

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Section: Discussionsupporting

confidence: 37%

Section: Introductionmentioning

confidence: 99%

Impact of radiotherapy for head and neck cancer on obstructive sleep apnea: a prospective study

Inoshita¹,

Sata²,

Ohba³

et al. 2022

Ann Palliat Med

View full text Add to dashboard Cite

show abstract

“…Huyett et al found that 50% percent of patients treated with RT for HNC showed evidence of OSA (6). Piccin et al published two cases of severe obstructive sleep apnea induced by neck radiotherapy (7). Friedman et al showed that patients treated by RT for HNC had an incidence of OSA that is much higher that the normal middle aged population (8).…”

mentioning

confidence: 99%