Sleep apnea in patients with oral cavity and oropharyngeal cancer after surgery and chemoradiation therapy.
OBJECTIVE
To determine the point prevalence of sleep apnea in patients following oral and oropharyngeal cancer treatment at a major tertiary care referral center.


METHODS
A retrospective cross-sectional survey.


METHODS
Twenty-four patients with established oral or oropharyngeal cancer were submitted to overnight polysomnography. The surgical group consisted of 15 patients (11 male, 4 female; average age 64.2 yrs) having undergone primary surgery with radial forearm free flap reconstruction. The remaining patients (5 male, 4 female; average age 54.8 yrs) were treated nonsurgically with chemoradiation therapy. The fatigue-related daytime sleepiness was measured with the Epworth sleepiness scale (ESS).


RESULTS
Eleven patients in the surgical group and three in the nonsurgical group had a respiratory disturbance index (RDI) greater than 15 (odds ratio = 5.5, P = 0.092). Twelve patients in the surgical group and five in the nonsurgical group had significant oxygen desaturation during sleep hours (odds ratio = 3.3, P = 0.356). There was no observed significant correlation between RDI and oxygen desaturation (r(2) = 0.28), nor was there any observed association between the RDI and ESS score (r(2) = 0.18).


CONCLUSIONS
This preliminary study has suggested that surgical patients in our cohort have a higher prevalence of moderate to severe obstructive sleep apnea in the postoperative period, when tested, compared with a nonsurgical group. A small sample size and incomplete matching on important cofactors of interest, such as primary site location, body mass index, and thyroid function, limit this study. A pretreatment and post-treatment analysis is obviously required to demonstrate any significant level of association between treatment type and sleep apnea status.
Qian
Wei
W
Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Haight
James
J
Poon
Ian
I
Enepekides
Dan
D
Higgins
Kevin M
KM
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D017286:Polysomnography; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000209:etiology*; D013524:Surgical Flaps