Obstructive sleep apnea in patients with head and neck cancer: a systematic review.

STUDY OBJECTIVES Head and neck cancers (HNC) may modify the upper airway anatomy and thereby increase the risk for obstructive sleep apnea (OSA). If untreated, OSA is associated with adverse outcomes. Identification of risk factors for OSA in patients with HNC is essential to promote proper evaluation, treatment, and improvement of sleep-related outcomes. In this review, we assessed associations between tumor stage, cancer treatment, and OSA in the population with HNC. METHODS A systematic search of PubMed, EMBASE (Embase.com), Cochrane Library (Cochranelibrary.com), Scopus, and Web of Science was conducted to identify articles related to OSA in patients with HNC. A total of 215 articles were identified, of which 14 were included in the qualitative synthesis. These studies included 387 participants. RESULTS The most common cancer type, tumor location, and cancer therapy were squamous cell carcinoma, oropharynx, and surgery, respectively. Three of six articles reported an association between surgical treatment and OSA. Conversely, associations between tumor stage, radiotherapy, and OSA were found in only a minority of studies (15%). Prevalence of OSA was between 57-76% pre-cancer therapy and 12-96% afterward. CONCLUSIONS This review suggests a potential association between HNC surgery and OSA. An association between tumor stage, radiotherapy to the head and neck and OSA is inconclusive. Further research is needed to examine the relationship between HNC and OSA.