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

Christopher Seifen,Tilman Huppertz,Christoph Matthias,Haralampos Gouveris

doi:10.3390/medicina57111174

Christopher Seifen, Tilman Huppertz + Show 2 more

Open Access

https://doi.org/10.3390/medicina57111174

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Abstract

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.

Highlights

Introduction than Just aComorbidity? MedicinaObstructive sleep apnea (OSA) is the most common type of sleep-disordered breathing, with a prevalence ranging between 4% and 24% in middle-aged people [1]
We describe the comorbidity of OSA in patients with head and neck cancer
The aforementioned studies show that OSA is far more prevalent in patients with head and neck cancer compared to the general population

Summary

Obstructive Sleep Apnea and Cancer Risk

The clinical picture of OSA was first described by William Osler in 1918 [23]. OSA is characterized by recurrent episodes of partial or complete airway obstruction during sleep leading to repetitive apneas or hypopneas. The diagnosis of OSA is based on clinical symptoms, the existence of risk factors and sleep study evaluation (polysomnography, a portable home-based test). Broad epidemiological studies demonstrated increased cancer mortality of patients with coexisting OSA compared to general population samples during follow-up [12,13]. A large multicenter cohort study by Justeau and colleagues found that nocturnal hypoxemia predicted all-cancer incidence in patients investigated for suspected OSA, independently of major confounding factors [39]. 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]

Obstructive Sleep Apnea Might Be a Relevant Comorbidity of Head and

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