Sleep-disordered breathing in patients with newly diagnosed lung cancer.
BACKGROUND
There are currently no data on the prevalence of sleep-disordered breathing (SDB) in patients with newly-diagnosed lung cancer. This might be of interest given that SDB is associated with increased cancer incidence and mortality. Furthermore, intermittent hypoxia has been linked with tumor growth and progression. The aim of the current study was to investigate the prevalence of SDB in patients with newly-diagnosed lung cancer.


METHODS
Patients with newly-diagnosed lung cancer from three centers in Germany were screened for SDB using a two-channel screening system (ApneaLink™). SDB was defined as an apnea-hypopnea index of > 5/h, and was classified as mild if the AHI was 5-15/h whereas an AHI ≥15/h was classified as severe SDB. The presence of SDB-related symptoms was assessed using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI).


RESULTS
A total of 100 patients were included. The overall prevalence of SDB was 49%; 32 patients (32%) had mild SDB with a median AHI of 7.7/h (quartile [Q1 5.4/h, Q3 10.4/h]) and a median oxygen desaturation index of 8.5 [Q1 4.2/h; Q3 13.4/h] and seventeen patients (17%) had moderate to severe SDB with a median AHI of 25.2 [Q1 18/h, Q3 45.5/h] and a median oxygen desaturation index of 20.6/h [Q1 9.6/h, Q3 36.6/h]. Patients with moderate to severe SDB had mild daytime sleepiness (ESS score 8.24 ± 3.96 vs. 5.74 ± 3.53 in those without SDB vs. 6.22 ± 2.72 in those with mild SDB; p = 0.0343). The PSQI did not differ significantly between the three groups (p = 0.1137).


CONCLUSIONS
This study showed a high prevalence of SDB in patients with newly-diagnosed lung cancer. In these patients SDB was associated with intermittent hypoxia and increased daytime sleepiness. Additional research is needed to determine whether SDB influences prognosis and morbidity in patients with lung cancer.


TRIAL REGISTRATION
NCT02270853 (ClinicalTrials.gov), date of registration: 14th October 2014.
['Dreher|Michael|M|', 'Krüger|Stefan|S|', 'Schulze-Olden|Susanne|S|', 'Keszei|András|A|', 'Storre|Jan Hendrik|JH|', 'Woehrle|Holger|H|', 'Arzt|Michael|M|', 'Müller|Tobias|T|http://orcid.org/0000-0002-9801-3496']
D000368:Aged D015897:Comorbidity D006970:Disorders of Excessive Somnolence D005260:Female D005858:Germany D006801:Humans D000860:Hypoxia D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D009026:Mortality D010092:Oximetry D015995:Prevalence D012307:Risk Factors D012720:Severity of Illness Index D012891:Sleep Apnea Syndromes D000070263:Sleep Hygiene D012907:Smoking
Lung cancer Lung neoplasm, sleep-related disorders, sleep-related hypoxaemia Sleep apnea Sleep disorders