title: Impact of head and neck radiotherapy for patients with nasopharyngeal carcinoma on sleep-related breathing disorders.
abstract: OBJECTIVE
  Little is known about the relationships between sleep-related breathing disorders (SRBDs) and nasopharyngeal carcinoma (NPC).
  
  
  OBJECTIVE
  To clarify the impact of head and neck radiotherapy on SRBDs, we performed a pilot study to investigate the change of sleep architecture in patients with NPC before and after treatment.
  
  
  METHODS
  A retrospective review of a prospective data set of 18 patients with NPC (15 men and 3 women; mean age, 49.8 years) and symptoms of SRBD, who completed radiotherapy and underwent polysomnography before and after treatment at a university-affiliated tertiary referral center.
  
  
  METHODS
  Radiotherapy and/or chemotherapy were applied based on the NPC stage.
  
  
  METHODS
  Subjective SRBD symptoms, Epworth sleepiness scale score, snoring severity (visual analog scale, rated 0-10 by bed partner), and objective full-night polysomnographic parameters (apnea-hypopnea index [AHI], AHI in rapid eye movement [REM] sleep, central sleep apnea index, percentage of light sleep, percentage of deep sleep, percentage of REM sleep, sleep efficiency, sleep latency, arousal index, mean oxygen saturation, lowest oxygen saturation, desaturation index, and snoring index) were collected before and at least 6 months after treatment.
  
  
  RESULTS
  After treatment, Epworth sleepiness scale and snoring severity scores significantly decreased from a mean (SD) of 11.0 (5.0) to 7.8 (2.3) (P = .005) and 6.0 (3.4) to 2.8 (2.3) (P < .001), respectively. The AHI changed from 26.2 (28.4) to 21.67 (24.15) (P = .28). However, AHI increased in 8 of 18 patients. A statistically significant increase was shown in mean oxygen saturation, from 95.3% (2.0%) to 97.1% (1.4%) (P < .001), though lowest oxygen saturation was not significantly altered. Percentage of light sleep increased significantly from 78.9% (8.8%) to 86.1% (9.6%) (P = .02), and percentage of REM sleep decreased from 17.5% (6.4%) to 12.7% (8.9%) (P = .10). Percentage of deep sleep was not significantly altered.
  
  
  CONCLUSIONS
  Although the severity of apnea and hypopnea events and snoring decreased in most of the patients with NPC after treatment, the sleep architecture became disrupted and 8 of 18 of the patients had an increased AHI after treatment. Identification and treatment of obstructive sleep apnea and hypopnea in patients with NPC may be important factors for improving the quality of life.
authors.affiliation: Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital.
authors.forename: Hsin-Ching
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Department of Otolaryngology and Bronchoesophagology, Rush University Medical Center, Chicago, Illinois5Department of Otolaryngology, Advocate Illinois Masonic Medical Center, Chicago.
authors.forename: Michael
authors.initials: M
authors.lastname: Friedman
authors.affiliation: Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.
authors.forename: Hsueh-Wen
authors.initials: HW
authors.lastname: Chang
authors.affiliation: Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Fu-Min
authors.initials: FM
authors.lastname: Fang
authors.affiliation: Sleep Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lin
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan3Sleep Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung.
authors.forename: Mao-Chang
authors.initials: MC
authors.lastname: Su
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000150:complications / Q000503:physiopathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000150:complications / Q000503:physiopathology / Q000532:radiotherapy*; D010865:Pilot Projects; D017286:Polysomnography; D011446:Prospective Studies; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000209:etiology / Q000517:prevention & control