Association between radiotherapy and obstructive sleep apnea in cancer patients: A systematic review and meta-analysis.

Abstract

e17576 Background: With the increase in survival of cancer patients, consequently, increasing their quality of life is mandatory as well. Sleep disturbances, particularly Obstructive Sleep Apnea (OSA), is one of the main complaints of cancer patients in which patients face frequent episodes of upper airway closure during sleep. Possible causes for OSA include either the specific cancer or its treatment whether sedatives, narcotics, radiotherapy, or chemotherapy, but the primary cause is still hard to prove. Our aim was to investigate the association between the occurrence of OSA and radiotherapy in cancer patients. Methods: On the 9th of September, 2018, we have searched comprehensively 12 electronic databases to retrieve relevant studies. All eligible studies that assess the association between OSA and radiotherapy in cancer patients were included in our meta-analysis. Quality assessment of included studies was done using the NIH tool for cohort and cross-sectional studies. Results: Fourteen studies met our selection criteria, eight studies were eligible for our meta-analysis. There was a positive association between the occurrence of OSA and radiotherapy in cancer patients (OR 1.16, 95% CI [0.52–2.56]; P = 0.718). OSA was noted in 103 of 181 cancer patients who received radiotherapy, yielding a remarkable overall prevalence of 63% (95% CI [0.36–0.85]; P = 0.343). A positive risk ratio for the development of OSA in cancer patients treated with radiotherapy was detected (RRs 1.27, 95% CI [0.81–2.00]; P = 0.297). The overall mean of apnea hypopnea index (AHI) for patients with OSA in six studies was 22.45. Conclusions: These findings point to a striking association between OSA risk and radiotherapy in cancer patients. Since the early recognition and management of OSA in such patients may play an important role in improving their quality of life, we recommend screening all cancer patients treated with radiation for early signs of OSA to further improve their survival.

The global prevalence of oropharyngeal dysphagia in different populations: a systematic review and meta-analysis

“…Kertscher et al reported that the prevalence of OD in the population over 75 years old is more than other age groups [ 11 ], which is consistent with the results of the present study. Many physiological changes occur in body tissue with aging, such as muscle wasting, reduced endurance capacity, and muscle weakness [ 48 , 49 ], hormonal changes and decreased ratio of anabolic to catabolic hormones [ 50 ], increased rates of neurological diseases [ 51 – 53 ], cardiovascular diseases [ 54 ], atrophy of the pharyngeal and laryngeal muscles [ 55 ], and many other chronic diseases. Considering these conditions in the treatment process and the improvement of the clinical outcomes of the elderly population can be helpful.…”

Concordance between self-reported sleep and actigraphy-assessed sleep in adult survivors of childhood cancer: the impact of psychological and neurocognitive late effects

“…For instance, craniopharyngioma survivors have a high rate of excessive daytime sleepiness and meet criteria for secondary narcolepsy and hypersomnia[ 36 ], related to the degree of hypothalamic involvement of their tumor[ 5 ]. Survivors who receive radiation therapy have an increased risk of obstructive sleep apnea[ 37 ], which may be related to thoracic radiation that has structurally changed survivors’ upper airway systems. Insomnia, a multifactorial sleep disorder, may present differently in cancer survivors due to several perpetuating factors that can be associated with survivorship, psychological distress, fatigue, pain, hormonal disruptions, and chronic health conditions associated with treatment exposures[ 38 – 40 , 4 ].…”