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Sleep Med. 2014 Jul;15(7):742-8. doi: 10.1016/j.sleep.2014.01.020. Epub 2014 May 15.

Obstructive sleep apnea is associated with cancer mortality in younger patients.

Author information

1
Respiratory Department, La Fe University and Polytechnic Hospital, Valencia, Spain; CIBER de Enfermedades Respiratorias, Bunyola, Spain. Electronic address: mianmartinezgarcia@gmail.com.
2
Respiratory Department, Valme University Hospital, Sevilla, Spain.
3
Alava University Hospital, Vitoria, Spain; CIBER de Enfermedades Respiratorias, Bunyola, Spain.
4
Respiratory Department, Son Espases University Hospital, Palma de Mallorca, Spain; CIBER de Enfermedades Respiratorias, Bunyola, Spain.
5
Respiratory Department, Corporació Sanitaria Parc Tauli Hospital, Sabadell, Spain; CIBER de Enfermedades Respiratorias, Bunyola, Spain.
6
Respiratory Department, Marques de Valdecilla Hospital, Santander, Spain.
7
Respiratory Department, Rio Hortega Hospital, Valladolid, Spain; CIBER de Enfermedades Respiratorias, Bunyola, Spain.
8
Respiratory Unit, Requena General Hospital, Valencia, Spain.
9
Respiratory Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
10
Respiratory Department, Miguel Servet Hospital, Zaragoza, Spain.
11
Respiratory Department, Arnau de Vilanova Hospital, IRB, Lleida, Spain; CIBER de Enfermedades Respiratorias, Bunyola, Spain.
12
IRB Lleida, Lleida, Spain; CIBER de Enfermedades Respiratorias, Bunyola, Spain.
13
Facultat de Medicina, Universitat de Barcelona University, IDIBAPS, Spain; CIBER de Enfermedades Respiratorias, Bunyola, Spain.
14
Respiratory Department, Clinic Hospital-IDIBAPS, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Bunyola, Spain.

Abstract

OBJECTIVE:

The association between obstructive sleep apnea (OSA) and cancer mortality has scarcely been studied. The objective of this study was to investigate whether OSA is associated with increased cancer mortality in a large cohort of patients with OSA suspicion.

METHODS:

This was a multicenter study in consecutive patients investigated for suspected OSA. OSA severity was measured by the apnea-hypopnea index (AHI) and the hypoxemia index (% night-time spent with oxygen saturation <90%, TSat90). The association between OSA severity and cancer mortality was assessed using Cox's proportional regression analyses after adjusting for relevant confounders.

RESULTS:

In all, 5427 patients with median follow-up of 4.5 years were included. Of these, 527 (9.7%) were diagnosed with cancer. Log-transformed TSat90 was independently associated with increased cancer mortality in the entire cohort (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.03-1.42), as well as in the group of patients with cancer (HR, 1.19; 95% CI, 1.02-1.41). The closest association was shown in patients <65years in both the AHI (continuous log-transformed AHI: HR, 1.87; 95% CI, 1.1-3.2; upper vs lower AHI tertile: HR, 3.98; 95% CI, 1.14-3.64) and the TSat90 (continuous log-transformed TSat90: HR, 1.73; 95% CI, 1.23-2.4; upper vs. lower TSat90 tertile: HR, 14.4; 95% CI, 1.85-111.6).

CONCLUSIONS:

OSA severity was associated with increased cancer mortality, particularly in patients aged <65 years.

KEYWORDS:

Cancer; Intermittent hypoxemia; Mortality; Obstructive sleep apnea; Sleep apnea; Sleep-disordered breathing

PMID:
24907033
DOI:
10.1016/j.sleep.2014.01.020
[Indexed for MEDLINE]

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