Obstructive sleep apnea in head and neck cancer survivors

Head and Neck Cancer

Saesen K, et al. Support Care Cancer 2020.


IMPORTANCE: Chronic fatigue is present in 33.0% of all head and neck cancer (HNC) survivors; this impacts their quality of life negatively. A plausible cause is obstructive sleep apnea (OSA) after HNC treatment. However, studies regarding this topic are scarce.

OBJECTIVE: To confirm if OSA is more prevalent after receiving radiotherapy for HNC. In addition, investigation of the risk factors for developing OSA in this population.

DESIGN: A retrospective review of prospective data.

METHODS: Treatment for HNC took place between 2016 and 2017 at the University Hospital of Leuven. One hundred sixty-four patients were eligible for participating in this study. Sixty-five responded (39.4%). Upon consulting their medical files, 15 patients were excluded based on the in- and exclusion criteria. Presence of OSA was estimated using standardized questionnaires, namely the Berlin Questionnaire, the Epworth Sleepiness Scale, and the CIS-20. This was compared to the proportion of OSA in the general population.

RESULTS: Fifty patients (33 men, 17 women) with a mean age of 64.2 years (range 32-88) were included. Based on the questionnaires, OSA was suspected in twenty. The prevalence of suspected OSA in our study group (40.0%) was significantly greater (p < 0.0001) than our estimated prevalence of OSA in the general population (10.9%). No significant risk factors could be identified.

CONCLUSION: Patients treated for HNC are at risk of developing OSA. When complaints of fatigue and sleeping problems persist, referral to a sleep clinic is suggested. Further investigation remains necessary to identify potential risk factors along with prevention and treatment strategies.