Obstructive sleep apnea is associated with cancer mortality in younger patients

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• 作者：Miguel A. Martí ; nez-Garcí ; a^a ; ⁿ ; ^{mianmartinezgarcia@gmail.com" class="auth_mail} ; Francisco Campos-Rodriguez^b ; Joaquí ; n Durá ; n-Cantolla^c ; ⁿ ; Mó ; nica de la Peñ ; a^d ; ⁿ ; Marí ; a J. Masdeu^e ; ⁿ ; Mó ; nica Gonzá ; lez^f ; Fé ; lix del Campo^g ; ⁿ ; Pablo Catalá ; n Serra^h ; Irene Valero-Sá ; nchez^a ; M.J. Selma Ferrer^a ; José ; M. Marí ; nⁱ ; Ferrá ; n Barbé ; ^j ; ⁿ ; M. Martí ; nez^k ; ⁿ ; Ramó ; n Farré ; ^l ; ⁿ ; José ; M. Montserrat^m ; ⁿ ; on behalf of the Spanish Sleep Network
• 关键词：Sleep apnea ; Sleep-disordered breathing ; Cancer ; Mortality ; Intermittent hypoxemia ; Obstructive sleep apnea
• 刊名：Sleep Medicine
• 出版年：July 2014
• 年：2014
• 卷：15
• 期：7
• 页码：742-748
• 全文大小：499 K

文摘

The association between obstructive sleep apnea (OSA) and cancer mortality has scarcely been studied. The objective of this study was to investigate whether OSA is associated with increased cancer mortality in a large cohort of patients with OSA suspicion.

Methods

This was a multicenter study in consecutive patients investigated for suspected OSA. OSA severity was measured by the apnea–hypopnea index (AHI) and the hypoxemia index (% night-time spent with oxygen saturation <90%, TSat₉₀). The association between OSA severity and cancer mortality was assessed using Cox’s proportional regression analyses after adjusting for relevant confounders.

Results

In all, 5427 patients with median follow-up of 4.5 years were included. Of these, 527 (9.7%) were diagnosed with cancer. Log-transformed TSat₉₀ was independently associated with increased cancer mortality in the entire cohort (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.03–1.42), as well as in the group of patients with cancer (HR, 1.19; 95% CI, 1.02–1.41). The closest association was shown in patients <65 years in both the AHI (continuous log-transformed AHI: HR, 1.87; 95% CI, 1.1–3.2; upper vs lower AHI tertile: HR, 3.98; 95% CI, 1.14–3.64) and the TSat₉₀ (continuous log-transformed TSat₉₀: HR, 1.73; 95% CI, 1.23–2.4; upper vs lower TSat₉₀ tertile: HR, 14.4; 95% CI, 1.85–111.6).

Conclusions

OSA severity was associated with increased cancer mortality, particularly in patients aged <65 years.