Associations of self-reported obstructive sleep apnea with total and site-specific cancer risk in older women: a prospective study

Abstract Background and Objectives Chronic intermittent hypoxia resulting from obstructive sleep apnea (OSA) may activate multiple carcinogenic pathways and lead to cancer development. Methods We prospectively examined the association between OSA and cancer risk among 65,330 women in the Nurses’ Health Study who were free of cancer in 2008 (mean age: 73.3 years). Incident cancer diagnoses were collected until 2016 and confirmed by pathology reports. Clinically diagnosed OSA was self-reported in 2008 and updated in 2012. We used time-dependent Cox regression to estimate hazard ratios (HR) for the associations of OSA with total and site-specific cancer risk. Results We documented 5,257 incident cancer diagnoses during follow-up. In the age-adjusted model, OSA was associated with a 15% (95% CI: 1.03, 1.29) increase in total cancer risk. The association became nonsignificant after adjustment for multiple cancer risk factors (HR: 1.08; 95% CI: 0.96, 1.21). When examining cancer risk by site, OSA was associated with significantly increased risk for lung (fully adjusted HR: 1.52; 95% CI: 1.07, 2.17), bladder (fully adjusted HR: 1.94; 95% CI: 1.12, 3.35), and thyroid cancer (fully adjusted HR: 2.06; 95% CI: 1.01, 4.22) and possibly increased risk for kidney cancer (fully adjusted HR: 1.59; 95% CI: 0.84, 3.01). When grouping cancer sites by risk factor profiles, OSA was positively associated with smoking-related cancers (fully adjusted HR: 1.37; 95% CI: 1.11, 1.67), and this association was stronger in never smokers than ever smokers. Conclusion While OSA was not independently associated with overall cancer risk in older women, significant associations were observed for smoking-related cancers, especially in nonsmokers.

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0493 Associations of Obstructive Sleep Apnea with Total and Site-specific Cancer Risk in Elderly Women: A Prospective Study

SLEEP ◽

10.1093/sleep/zsz067.491 ◽

2019 ◽

Vol 42 (Supplement_1) ◽

pp. A197-A198

Author(s):

Tianyi Huang ◽

Brian Lin ◽

Meir Stampfer ◽

Eva Schernhammer ◽

Richa Saxena ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cancer Risk ◽

Prospective Study ◽

Elderly Women ◽

Site Specific ◽

Obstructive Sleep ◽

Specific Cancer ◽

A Prospective Study

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Obstructive Sleep Apnea Patients Having Surgery Are Less Associated with Glaucoma

Journal of Ophthalmology ◽

10.1155/2014/838912 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Hsin-Yi Chen ◽

Yue-Cune Chang ◽

Che-Chen Lin ◽

Fung-Chang Sung ◽

Wen-Chi Chen

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cox Regression ◽

Population Based ◽

Multiple Modalities ◽

Obstructive Sleep ◽

Increased Risk ◽

Artery Disease ◽

Using Data ◽

Estimate Hazard Ratio

Objective.To investigate if different treatment strategy of obstructive sleep apnea (OSA) was associated glaucoma risk in Taiwanese population.Methods.Population-based retrospective cohort study was conducted using data sourced from the Longitudinal Health Insurance Database 2000. We included 2528 OSA patients and randomly selected and matched 10112 subjects without OSA as the control cohort. The risk of glaucoma in OSA patients was investigated based on the managements of OSA (without treatment, with surgery, with continuous positive airway pressure (CPAP) treatment, and with multiple modalities). The multivariable Cox regression was used to estimate hazard ratio (HR) after adjusting for sex, age, hypertension, diabetes, hyperlipidemia, and coronary artery disease.Results.The adjusted HR of glaucoma for OSA patients was 1.88 (95% CI: 1.46–2.42), compared with controls. For patients without treatment, the adjusted HR was 2.15 (95% CI: 1.60–2.88). For patients with treatments, the adjusted HRs of glaucoma were not significantly different from controls, except for those with CPAP (adjusted HR = 1.65, 95% CI = 1.09–2.49).Conclusions.OSA is associated with an increased risk of glaucoma. However, surgery reduces slightly the glaucoma hazard for OSA patients.

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Abstract 15777: Association Between Sleep Disordered Breathing, Obstructive Sleep Apnea and Incident Cancer: A Systematic Review and Meta-Analysis

Circulation ◽

10.1161/circ.130.suppl_2.15777 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Ghanshyam Palamaner Subash Shantha ◽

Anita A Kumar ◽

Lawrence J Cheskin ◽

Samir B Pancholy

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Head And Neck ◽

Sleep Disordered Breathing ◽

Meta Analysis ◽

Incident Cancer ◽

Obstructive Sleep ◽

Increased Risk ◽

Disordered Breathing

Introduction: Sleep disordered breathing (SDB) and obstructive sleep apnea (OSA) increase risk for multiple morbidities such as cardiovascular events, diabetes mellitus, and hypertension. Association between SDB and incident cancer is unclear and studies that assessed this association have yielded conflicting results. Hypothesis: We systematically reviewed the literature and pooled available evidence that has associated SDP and incident cancer. Methods: Medline, Embase, Cochrane central library, and electronic databases were searched for relevant studies. Studies were included if: 1) they studied patients with SDB, and 2) reported rates of incident cancer. We excluded studies that reported cancers involving head and neck as we suspected reverse causation, since head and neck cancers can lead to SDP. Data were pooled using a random-effects model. Results: From 3522 retrieved citations, 7 observational studies were included in the review. Of these, 4 studies, representing 48,152 patients with SDB and 87,849 patients without SDB, were included in the meta-analysis. In total 6931 incident cancer cases were reported (2813 in SDB group and 4118 in non-SDB group). In the pooled analysis, patients with SDB experienced higher odds of incident cancer (OR: 1.30, 95% CI: 1.06 - 1.60, P = 0.01, I 2 : 75%, 4 included studies) compared to those without SDB. Data from 2 studies that assessed patients with OSA, showed that OSA increased risk for incident cancer at 5 years follow-up (OR: 1.90, 95% CI: 1.46 - 2.45, P < 0.001, I 2 : 0%) and 8 years follow-up (OR: 1.54, 95% CI: 1.25 - 1.88, P < 0.001, I 2 : 0%). Also, cancer risk (OR: 1.28, 95% CI: 1.09 - 1.51, P = 0.003, I 2 : 21%, 2 studies) and cancer mortality (OR: 1.84, 95% CI: 1.32 - 2.56, P = 0.003, I 2 : 0%, 2 studies) was significant only in patients with severe OSA [apnea-hypopnea index (AHI) > 30] and not in patients with mild to moderate OSA (AHI < 30). Factors namely; obesity, type of cancer, age and gender did not account for between study heterogeneity. Conclusions: SDB and OSA are associated with incident cancer. Though our study did not support the role of obesity in this association, strong mechanistic link exists, associating SDB, obesity and cancer. Future studies should assess the association between SDB and organ specific cancers.

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827 Central Sleep Apnea in a patient with Multiple Sclerosis

SLEEP ◽

10.1093/sleep/zsab072.824 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A322-A323

Author(s):

Rahul Dasgupta ◽

Sonja Schütz ◽

Tiffany Braley

Keyword(s):

Multiple Sclerosis ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Disordered Breathing ◽

Central Sleep Apnea ◽

Progressive Multiple Sclerosis ◽

Obstructive Sleep ◽

Increased Risk ◽

Demyelinating Lesions ◽

The Brain

Abstract Introduction Sleep-disordered breathing is common in persons with multiple sclerosis (PwMS), and may contribute to debilitating fatigue and other chronic MS symptoms. The majority of research to date on SDB in MS has focused on the prevalence and consequences of obstructive sleep apnea; however, PwMS may also be at increased risk for central sleep apnea (CSA), and the utility of methods to assess CSA in PwMS warrant further exploration. We present a patient with secondary progressive multiple sclerosis who was found to have severe central sleep apnea on WatchPAT testing. Report of case(s) A 61 year-old female with a past medical history of secondary progressive multiple sclerosis presented with complaints of fragmented sleep. MRI of the brain, cervical spine, and thoracic spine showed numerous demyelinating lesions in the brain, brainstem, cervical, and thoracic spinal cord. Upon presentation, the patient noted snoring, witnessed apneas, and daytime sleepiness. WatchPAT demonstrated severe sleep apnea, with a pAHI of 63.3, and a minimum oxygen saturation of 90%. The majority of the scored events were non-obstructive in nature (73.1% of all scored events), and occurred intermittently in a periodic fashion. Conclusion The differential diagnosis of fatigue in PwMS should include sleep-disordered breathing, including both obstructive and central forms of sleep apnea. Demyelinating lesions in the brainstem (which may contribute to impairment of motor and sensory networks that control airway patency and respiratory drive), and progressive forms of MS, have been linked to both OSA and CSA. The present data illustrate this relationship in a person with progressive MS, and offer support for the WatchPAT as a cost-effective means to evaluate for both OSA and CSA in PwMS, while reducing patient burden. PwMS may be at increased risk for CSA. Careful clinical consideration should be given to ordering appropriate sleep testing to differentiate central from obstructive sleep apnea in PwMS, particularly for patients with demyelinating lesions in the brainstem. Support (if any) 1. Braley TJ, Segal BM, Chervin RD. Obstructive sleep apnea and fatigue in patients with multiple sclerosis. J Clin Sleep Med. 2014 Feb 15;10(2):155–62. doi: 10.5664/jcsm.3442. PMID: 24532998; PMCID: PMC3899317.

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Increased Risk of Parkinsonʼs Disease in Patients With Obstructive Sleep Apnea

Medicine ◽

10.1097/md.0000000000002293 ◽

2016 ◽

Vol 95 (2) ◽

pp. e2293 ◽

Cited By ~ 31

Author(s):

Nai-Cheng Yeh ◽

Kai-Jen Tien ◽

Chun-Ming Yang ◽

Jhi-Joung Wang ◽

Shih-Feng Weng

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep ◽

Increased Risk

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Compared to Individuals with Mild to Moderate Obstructive Sleep Apnea (OSA), Individuals with Severe OSA Had Higher BMI and Respiratory-Disturbance Scores

Life ◽

10.3390/life11050368 ◽

2021 ◽

Vol 11 (5) ◽

pp. 368

Author(s):

Leeba Rezaie ◽

Soroush Maazinezhad ◽

Donald J. Fogelberg ◽

Habibolah Khazaie ◽

Dena Sadeghi-Bahmani ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Multiple Regression ◽

Daytime Sleepiness ◽

Respiratory Disturbance Index ◽

Disturbance Index ◽

Related Data ◽

Obstructive Sleep ◽

Increased Risk ◽

Respiratory Disturbance

Objective: Individuals with obstructive sleep apnea (OSA) are at increased risk to suffer from further somatic and sleep-related complaints. To assess OSA, demographic, anthropometric, and subjective/objective sleep parameters are taken into consideration, but often separately. Here, we entered demographic, anthropometric, subjective, and objective sleep- and breathing-related dimensions in one model. Methods: We reviewed the demographic, anthropometric, subjective and objective sleep- and breathing-related data, and polysomnographic records of 251 individuals with diagnosed OSA. OSA was considered as a continuous and as categorical variable (mild, moderate, and severe OSA). A series of correlational computations, X2-tests, F-tests, and a multiple regression model were performed to investigate which demographic, anthropometric, and subjective and objective sleep dimensions were associated with and predicted dimensions of OSA. Results: Higher apnea/hypopnea index (AHI) scores were associated with higher BMI, higher daytime sleepiness, a higher respiratory disturbance index, and higher snoring. Compared to individuals with mild to moderate OSA, individuals with severe OSA had a higher BMI, a higher respiratory disturbance index (RDI) and a higher snoring index, while subjective sleep quality and daytime sleepiness did not differ. Results from the multiple regression analysis showed that an objectively shorter sleep duration, more N2 sleep, and a higher RDI predicted AHI scores. Conclusion: The pattern of results suggests that blending demographic, anthropometric, and subjective/objective sleep- and breathing-related data enabled more effective discrimination of individuals at higher risk for OSA. The results are of practical and clinical importance: demographic, anthropometric, and breathing-related issues derived from self-rating scales provide a quick and reliable identification of individuals at risk of OSA; objective assessments provide further certainty and reliability.

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Abstract P068: Obstructive Sleep Apnea is Associated with an Increase Risk of Osteoporosis

Circulation ◽

10.1161/circ.131.suppl_1.p068 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Anawin Sanguankeo ◽

Sikarin Upala

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Primary Outcome ◽

Meta Analysis ◽

Systemic Disease ◽

Obstructive Sleep ◽

Increased Risk ◽

Increase Risk ◽

Osteoporosis Risk ◽

Stimulation Of

Background: Obstructive sleep apnea (OSA) is thought to be a systemic disease and has been associated with many disorders such as metabolic, endocrine, and especially cardiovascular diseases. One of the consequences of OSA is hypoxia, which can lead to a reduction in growth of osteoblast and a stimulation of osteoclast. Our meta-analysis was conducted to determine the risk of osteoporosis in patients with OSA compared to controls. Objectives: Eligible studies assessing the effects of obstructive sleep apnea on osteoporosis risk were comprehensively searched in PubMed/MEDLINE, EMBASE, and CENTRAL from their inception to September 2014. Two authors independently assessed article quality and extracted the data. Primary outcome were number of participants, prevalence, or risk ratio of osteoporosis in OSA and controls. Results: From 40 full-text articles, 3 studies involving 113,090 participants were included in the meta-analysis that were based on the random effects model. Compared with controls, participants who were diagnosed with obstructive sleep apnea had increased risk of osteoporosis (pooled risks ratio, 1.85; 95% CI, 1.34, 2.56). Conclusion: Patients with OSA had a higher risk of developing osteoporosis. Further study is needed to evaluate the possible mechanisms between these two conditions and to find potential treatment for OSA that could prevent osteoporosis.

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

Respiration ◽

10.1159/000486577 ◽

2018 ◽

Vol 97 (1) ◽

pp. 15-23 ◽

Cited By ~ 18

Author(s):

Ronen Brenner ◽

Shaye Kivity ◽

Marina Peker ◽

Daniel Reinhorn ◽

Lital Keinan-Boker ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Young Patients ◽

Severe Obstructive Sleep Apnea ◽

Obstructive Sleep ◽

Increased Risk

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Defining Risk of Postoperative Obstructive Sleep Apnea in Patients With 22q11.2DS Undergoing Pharyngeal Flap Surgery for Velopharyngeal Dysfunction Using Polysomnographic Evaluation

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665619900871 ◽

2020 ◽

Vol 57 (7) ◽

pp. 808-818

Author(s):

Alfred Lee ◽

Brian L. Chang ◽

Cynthia Solot ◽

Terrence B. Crowley ◽

Vamsee Vemulapalli ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Tertiary Care ◽

22Q11.2 Deletion Syndrome ◽

Deletion Syndrome ◽

Apnea Hypopnea Index ◽

Pressure Therapy ◽

Obstructive Sleep ◽

Increased Risk ◽

Pharyngeal Flap

Objective: To determine pre- and postoperative prevalence of obstructive sleep apnea (OSA) in patients with 22q11.2 deletion syndrome (DS) undergoing wide posterior pharyngeal flap (PPF) surgery for velopharyngeal dysfunction (VPD). Design: Retrospective study using pre- and postoperative polysomnography (PSG) to determine prevalence of OSA. Medical records were reviewed for patients’ medical comorbidities. Parents were surveyed about snoring. Setting: Academic tertiary care pediatric hospital. Patients: Forty patients with laboratory confirmed 22q11.2DS followed over a 6-year period. Interventions: Pre- and postoperative PSG, speech evaluation, and parent surveys. Main Outcome Measure: Severity and prevalence of OSA, defined by obstructive apnea hypopnea index (OAHI), before and after PPF surgery to determine whether PPF is associated with increased risk of OSA. Results: Mean OAHI did not change significantly after PPF surgery (1.1/h vs 2.1/h, P = .330). Prevalence of clinically significant OSA (OAHI ≥ 5) was identical pre- and postoperatively (2 of 40), with both cases having severe-range OSA requiring positive airway pressure therapy. All other patients had mild-range OSA. Nasal resonance was graded as severe preoperatively in 85% of patients. None were graded as severe postoperatively. No single patient factor or parent-reported concern predicted risk of OSA (OAHI ≥ 1.5). Conclusions: Patients with 22q11.2DS are medically complex and are at increased risk of OSA at baseline. Wide PPF surgery for severe VPD does not significantly increase risk of OSA. Careful perioperative planning is essential to optimize both speech and sleep outcomes.

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