Tilman Huppertz1, Vera Horstmann2, Charlotte Scharnow2, Christian Ruckes3, Katharina Bahr2, Christoph Matthias2, Haralampos Gouveris2. 1. Sleep Center of the Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany. Tilman.huppertz@unimedizin-mainz.de. 2. Sleep Center of the Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany. 3. Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Abstract
PURPOSE: Obstructive sleep apnea (OSA) is associated with severe daytime sleepiness and reduced quality of life. These symptoms are also present in patients with squamous cell carcinoma of the head and neck (SCCHN) before, during and after treatment, so that comorbidity cannot be excluded. The aim was to evaluate the prevalence of OSA and its impact on the quality of life in patients with oropharyngeal, hypopharyngeal and lateral tongue SCCHN in a prospective study. METHODS: We performed cardiorespiratory home sleep apnea testing and recorded sleep-related patient-reported outcomes in 33 patients with confirmed oropharyngeal, hypopharyngeal and lateral tongue SCCHN. We correlated the sleep-related variables to oncologic variables and endpoints. RESULTS: Five female and 28 male patients with SCCHN (aged 46-77 years) were recruited. Thirty patients (90%) had OSA as defined by an Apnea/Hypopnea Index (AHI) > 5 /h before treatment. Evaluation after treatment, which was possible in 17 patients, showed OSA in 16 patients (94%). Radiologic primary tumor size showed significant positive correlation with AHI and apnea-index. Tumor recurrence and tumor-related mortality showed significant positive association with AHI. PSQI of these patients showed at least a moderate sleep disturbance. EORTC QLQ c30 questionnaire showed reduced values for all tested qualities, in particular for fatigue, insomnia, pain and financial distress. CONCLUSION: Obstructive sleep apnea is a significant comorbidity in patients with SCCHN. Pre-interventional AHI may be correlated with the oncologic outcome. Further research is needed to further describe the course of OSA and its treatment before, during and after therapy.
PURPOSE:Obstructive sleep apnea (OSA) is associated with severe daytime sleepiness and reduced quality of life. These symptoms are also present in patients with squamous cell carcinoma of the head and neck (SCCHN) before, during and after treatment, so that comorbidity cannot be excluded. The aim was to evaluate the prevalence of OSA and its impact on the quality of life in patients with oropharyngeal, hypopharyngeal and lateral tongue SCCHN in a prospective study. METHODS: We performed cardiorespiratory home sleep apnea testing and recorded sleep-related patient-reported outcomes in 33 patients with confirmed oropharyngeal, hypopharyngeal and lateral tongue SCCHN. We correlated the sleep-related variables to oncologic variables and endpoints. RESULTS: Five female and 28 male patients with SCCHN (aged 46-77 years) were recruited. Thirty patients (90%) had OSA as defined by an Apnea/Hypopnea Index (AHI) > 5 /h before treatment. Evaluation after treatment, which was possible in 17 patients, showed OSA in 16 patients (94%). Radiologic primary tumor size showed significant positive correlation with AHI and apnea-index. Tumor recurrence and tumor-related mortality showed significant positive association with AHI. PSQI of these patients showed at least a moderate sleep disturbance. EORTC QLQ c30 questionnaire showed reduced values for all tested qualities, in particular for fatigue, insomnia, pain and financial distress. CONCLUSION:Obstructive sleep apnea is a significant comorbidity in patients with SCCHN. Pre-interventional AHI may be correlated with the oncologic outcome. Further research is needed to further describe the course of OSA and its treatment before, during and after therapy.
Entities:
Keywords:
Cardiorespiratory home sleep apnea testing; Head and neck cancer; Obstructive sleep apnea; Quality of life
Authors: Terry Young; Laurel Finn; Paul E Peppard; Mariana Szklo-Coxe; Diane Austin; F Javier Nieto; Robin Stubbs; K Mae Hla Journal: Sleep Date: 2008-08 Impact factor: 5.849
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