Abstract
BackgroundThere are currently no data on the prevalence of sleep-disordered breathing (SDB) in patients with newly-diagnosed lung cancer. This might be of interest given that SDB is associated with increased cancer incidence and mortality. Furthermore, intermittent hypoxia has been linked with tumor growth and progression. The aim of the current study was to investigate the prevalence of SDB in patients with newly-diagnosed lung cancer.MethodsPatients with newly-diagnosed lung cancer from three centers in Germany were screened for SDB using a two-channel screening system (ApneaLink™). SDB was defined as an apnea-hypopnea index of > 5/h, and was classified as mild if the AHI was 5–15/h whereas an AHI ≥15/h was classified as severe SDB. The presence of SDB-related symptoms was assessed using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI).ResultsA total of 100 patients were included. The overall prevalence of SDB was 49%; 32 patients (32%) had mild SDB with a median AHI of 7.7/h (quartile [Q1 5.4/h, Q3 10.4/h]) and a median oxygen desaturation index of 8.5 [Q1 4.2/h; Q3 13.4/h] and seventeen patients (17%) had moderate to severe SDB with a median AHI of 25.2 [Q1 18/h, Q3 45.5/h] and a median oxygen desaturation index of 20.6/h [Q1 9.6/h, Q3 36.6/h]. Patients with moderate to severe SDB had mild daytime sleepiness (ESS score 8.24 ± 3.96 vs. 5.74 ± 3.53 in those without SDB vs. 6.22 ± 2.72 in those with mild SDB; p = 0.0343). The PSQI did not differ significantly between the three groups (p = 0.1137).ConclusionsThis study showed a high prevalence of SDB in patients with newly-diagnosed lung cancer. In these patients SDB was associated with intermittent hypoxia and increased daytime sleepiness. Additional research is needed to determine whether SDB influences prognosis and morbidity in patients with lung cancer.Trial registrationNCT02270853 (ClinicalTrials.gov), date of registration: 14th October 2014.
Highlights
There are currently no data on the prevalence of sleep-disordered breathing (SDB) in patients with newly-diagnosed lung cancer
The association between SDB and cancer remains to be clearly defined, previous studies have shown SDB to be associated with increased cancer incidence and cancer mortality. [4,5,6,7] it has been shown that sleep time with oxygen saturation below 90% has the strongest association with cancer mortality, highlighting the importance of hypoxemia
Moderate to severe SDB was present in 17%, whereas mild SDB (AHI 5 to < 15/h) was present in 32% of the patients
Summary
There are currently no data on the prevalence of sleep-disordered breathing (SDB) in patients with newly-diagnosed lung cancer. This might be of interest given that SDB is associated with increased cancer incidence and mortality. To the best of our knowledge, there is currently no published data on the prevalence of undiagnosed SDB in patients with newly-diagnosed lung cancer. This is relevant because the presence of SDB might influence morbidity and mortality in lung cancer patients and the treatment of intermittent hypoxia could influence the outcome or response to therapy. This study investigated the prevalence of SDB in patients with newly-diagnosed lung cancer
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