title: Sleep apnea in patients with oral cavity and oropharyngeal cancer after surgery and chemoradiation therapy.
abstract: 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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Wei
authors.initials: W
authors.lastname: Qian
authors.forename: James
authors.initials: J
authors.lastname: Haight
authors.forename: Ian
authors.initials: I
authors.lastname: Poon
authors.forename: Dan
authors.initials: D
authors.lastname: Enepekides
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Higgins
mesh_terms: 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