Obstructive Sleep Apnoea in Patients Treated for Head and Neck Cancer: A Systematic Review of the Literature.

Massimo Ralli,Marco De Vincentiis,Antonio Minni,Eugenia Allegra,Flaminia Campo,Antonella Polimeni,Antonio Greco,Diletta Angeletti

doi:10.3390/medicina56080399

Abstract

Background and objectives: Obstructive sleep apnoea (OSA) is clinically defined by signs of daytime sleepiness and objective measures of disordered breathing during sleep. The literature is still controversial on the incidence and aetiology of OSA secondary to head and neck cancer treatment. The aim of this systematic review is to evaluate and discuss the prevalence of OSA in patients treated with surgery and/or chemo/radiotherapy for head and neck cancer. Materials and methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was performed on May 2020 using the MEDLINE database, Scopus, and Google Scholar. The searches were conducted using combinations of the following terms: head and neck cancer, OSA, radiotherapy, chemotherapy, partial laryngectomy, laryngeal cancer, neoplasm, tumour, carcinoma, and oropharyngeal cancer. Results: Our results suggest that head and neck cancer patients have a higher incidence of OSA (59.78%) compared to the general population; differences may occur based on the type of treatment. Conclusions: Clinicians should recognise the higher prevalence of OSA in patients treated for head and neck cancer and should consider a comprehensive sleep history as part of the evaluation and management of these patients. Further research is needed to evaluate the exact prevalence, aetiology, and correct management of OSA after treatment for head and neck cancer.

Highlights

The most frequent type of sleep-disordered breathing in industrialised societies is obstructive sleep apnoea (OSA), with an incidence ranging between 3% and 7% in male and 2% and 5% in female middle-aged adults [1,2,3]
No patients who received total laryngectomy or that were breathing with the assistance of a tracheotomy/tracheostomy were included in the review; studies where the Apnoea-Hypopnoea Index (AHI) was not reported and studies with less than 10 patients were excluded
The full text of the included studies was reviewed with extraction of following data: (1) number of patients; (2) incidence of Obstructive sleep apnoea (OSA), (3) surgery treatment, (4) chemo/radiotherapy treatment, (5) AHI

Summary

Introduction

The most frequent type of sleep-disordered breathing in industrialised societies is obstructive sleep apnoea (OSA), with an incidence ranging between 3% and 7% in male and 2% and 5% in female middle-aged adults [1,2,3]. OSA is clinically defined by signs of daytime sleepiness and objective measures of disordered breathing during sleep [4]. Obstructive sleep apnoea (OSA) is clinically defined by signs of daytime sleepiness and objective measures of disordered breathing during sleep. The aim of this systematic review is to evaluate and discuss the prevalence of OSA in patients treated with surgery and/or chemo/radiotherapy for head and neck cancer. Results: Our results suggest that head and neck cancer patients have a higher incidence of OSA (59.78%) compared to the general population; differences may occur based on the type of treatment. Conclusions: Clinicians should recognise the higher prevalence of OSA in patients treated for head and neck cancer and should consider a comprehensive sleep history as part of the evaluation and management of these patients. Further research is needed to evaluate the exact prevalence, aetiology, and correct management of OSA after treatment for head and neck cancer

Methods

Discussion

Conclusion