Obstructive sleep apnea is associated with cancer mortality in younger patients

Martínez‐García, Miguel Ángel; Campos‐Rodríguez, Francisco; Durán-Cantolla, Joaquín; Peña, Mónica de la; Masdeu, María José; González, Mónica; Campo, Félix del; Serra, Pablo Catalán; Valero-Sanchez, I; Ferrer, Marcela; Marı́n, José Marı́a; Barbé, Ferrán; Martínez, Montserrat; Farré, Ramón; Montserrat, Josep M.

doi:10.1016/j.sleep.2014.01.020

Cited by 135 publications

(120 citation statements)

References 27 publications

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“…These results are in line with those obtained in a multicenter study in consecutive patients investigated for suspected OSA (6). OSA severity was measured by the AHI and the hypoxemia index (TSat90).…”

Section: Review Articlesupporting

confidence: 88%

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Clinical physiology and sleep: insights from the European Respiratory Society Congress 2017

et al. 2017

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Section: Review Articlesupporting

confidence: 88%

“…Recently, several studies have demonstrated that patients with OSA have a higher prevalence of cancer and cancer-related mortality (4,6). The average age of cancer diagnosis is 66 years with 25% of new diagnosis between 65-74 years.…”

Section: Spontaneous Tumorigenesis Induced By Intermittent Hypoxia Inmentioning

confidence: 99%

Clinical physiology and sleep: insights from the European Respiratory Society Congress 2017

et al. 2017

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“…The severe OSAS group had an increased risk of cancer-related death and all-cause death, with a relative risk of 3.8. Another larger study involving 5,427 patients with suspected OSAS demonstrated the same pattern of higher cancer mortality, particularly in patients under the age of 65 [46]. As cancer incidences in these 2 OSAS cohorts were not determined, the higher mortality rates in severe OSAS patients could not be specifically attributed to a higher cancer incidence.…”

Section: Discussionmentioning

confidence: 88%

Increased Risk for Cancer in Young Patients with Severe Obstructive Sleep Apnea

et al. 2018

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Background: Several studies in animal models and human with obstructive sleep apnea syndrome (OSAS) demonstrated an increase in cancer aggressiveness and mortality. However, there is a need for further clinical evidence supporting a correlation between OSAS and cancer incidence. Objectives: To reveal whether OSAS presence and severity is correlated with cancer incidence in a large homogenous patients’ cohort. Methods: We analyzed a cohort of over 5,000 concurrently enrolled patients, age > 18, with suspected OSAS, from a tertiary medical academic center. Patients underwent whole night polysomnography, the gold standard diagnostic tool for OSAS, and were classified for severity according to the Apnea Hypopnea Index (AHI). Data on cancer incidence were obtained from the Israel National Cancer Registry. A multivariate Cox proportional-hazards analysis, adjusted for age, gender, and BMI, was performed to estimate the hazard-ratio of new cancer incidence. Results: Among 5,243 subjects with a median follow-up of 5.9 years, 265 were diagnosed with cancer. The most prevalent cancers were prostate (14.7%), hematological (12.8%), urothelial (9.4%), colorectal (9%), and breast (8.3%). In subjects who were diagnosed at age below 45 years (n = 1,533), a high AHI (> 57/h) was significantly associated with cancer (HR 3.7, CI 1.12–12.45, p = 0.008). Conclusions: Patients younger than 45 with severe OSAS have a significantly higher all-type cancer incidence than the general population. These results should encourage clinicians to detect and diagnose young patients with suspected OSAS and to recommend cancer screening methods in this high-risk population.

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“…In that study, subjects with a T90 > 12% had twice the cancer risk compared to patients who spent less time with oxygen saturations below 90% during sleep (hazard ratio of 2.33, 95% CI 1.57-3.46). Another study found increased cancer mortality in patients with nocturnal hypoxemia especially among those with mean T90 > 13% (hazard ratio of 14.4, 95% CI 1.85-111.6) [20]. Furthermore, evidence from animal studies suggests that intermittent hypoxemia may condition tumor growth and progression [21,22].…”

Section: Discussionmentioning

confidence: 99%

Sleep Disordered Breathing Is Highly Prevalent in Patients with Lung Cancer: Results of the Sleep Apnea in Lung Cancer Study

et al. 2018

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Background: Obstructive sleep apnea (OSA) has been linked to tumorigenesis and tumor progression. Objectives: The Sleep Apnea in Lung Cancer (SAIL) study (NCT02764866) was designed to determine the prevalence of OSA in patients with lung cancer. Methods: Cross-sectional study including consecutive patients with newly diagnosed lung cancer. All patients were offered home sleep apnea testing (HSAT) and administered a sleep-specific questionnaire prior to initiating oncologic treatment. Sleep study-related variables, symptoms, and epidemiologic data as well as cancer related variables were recorded. Results: Eighty-three patients were enrolled in the SAIL study. Sixty-six completed HSAT. The mean age was 68 ± 11 years and 58% were male with a mean body mass index of 28.1 ± 5.4. Forty-seven percent were current smokers, 42% former smokers, and 11% never smokers with a median tobacco consumption of 51 pack-years. Fifty percent had COPD with a mean FEV1 of 83 ± 22.6% of predicted and a mean DLCO of 85.5 ± 20.1%. Adenocarcinoma was the most common histologic type (46.7%), followed by squamous cell (16.7%) and small cell (16.7%). Most patients were diagnosed at an advanced stage (65% in stages III–IV). The vast majority (80%) had OSA (apnea-hypopnea index [AHI] > 5), and 50% had moderate to severe OSA (AHI > 15) with a mean Epworth Sleepiness Score of 7.43 ± 3.85. Significant nocturnal hypoxemia was common (Median T90: 10.9% interquartile range 2.4–42.2). Conclusions: Sleep apnea and nocturnal hypoxemia are highly prevalent in patients with lung cancer.

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Obstructive sleep apnea is associated with cancer mortality in younger patients

Cited by 135 publications

References 27 publications

Clinical physiology and sleep: insights from the European Respiratory Society Congress 2017

Clinical physiology and sleep: insights from the European Respiratory Society Congress 2017

Increased Risk for Cancer in Young Patients with Severe Obstructive Sleep Apnea

Sleep Disordered Breathing Is Highly Prevalent in Patients with Lung Cancer: Results of the Sleep Apnea in Lung Cancer Study

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