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Kader MA, Sainudeen S, Khan AAG, Arora S, Ronsivalle V, Marrapodi MM, Cicciù M, Minervini G. Prevalence of obstructive sleep apnoea syndrome in oncological patients: A systematic review and meta-analysis. J Oral Rehabil 2024; 51:1236-1249. [PMID: 38528326 DOI: 10.1111/joor.13681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/27/2024] [Accepted: 03/02/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Obstructive sleep apnoea syndrome (OSAS) has garnered increasing attention in recent years due to its potential association with cancer. This systematic review and meta-analysis aimed to assess the prevalence of OSAS in cancer patients through a comprehensive analysis of existing literature. METHODS This systematic review and meta-analysis, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, aimed to evaluate the prevalence of OSAS in cancer patients. A comprehensive search of electronic databases was performed to identify relevant studies published up to September 2021. Eligible studies reporting on the prevalence of OSAS in cancer patients, encompassing various study designs, were included in the analysis. Pooled estimates of the odds ratios (OR) with 95% confidence intervals (CIs) were calculated using a random effects model. Heterogeneity among the studies was assessed using the I2 statistic. RESULTS Seventeen studies fulfilled the inclusion criteria and were subsequently included in the review. The prevalence of OSAS in cancer patients was estimated to have an overall OR of 0.80 (95% CI: 0.75-0.85). In comparison with non-cancer patients, cancer patients had a statistically significant greater risk of OSAS, as indicated by the total estimated RR for the prevalence of OSAS in cancer patients, which was 0.89 (95% CI: 0.86-0.92). Nonetheless, there was a significant amount of heterogeneity (I2 = 96%) among the studies. CONCLUSION The overall data analysed in this review indicates that patients with cancer had far reduced likelihood of developing OSAS than individuals without cancer. However, the significant variation across the included studies highlights the need for additional investigation to fully clarify the complex association between OSAS and cancer incidence. These results emphasise how critical it is to identify OSAS as a possible comorbidity in cancer patients, one that should be taken into account for clinical management and ongoing research.
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Affiliation(s)
- Mohammed Abdul Kader
- Department of Restorative Dental Science, College of Dentistry, King Khalid University Abha, Abha, Saudi Arabia
| | - Shan Sainudeen
- Department of Restorative Dental Science, College of Dentistry, King Khalid University Abha, Abha, Saudi Arabia
| | - Abdul Ahad Ghaffar Khan
- Department of Oral and Maxillofacial Surgery, King Khalid University College of Dentistry, Abha, Saudi Arabia
| | - Suraj Arora
- Department of Restorative Dental Science, College of Dentistry, King Khalid University Abha, Abha, Saudi Arabia
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, Largo Madonna delle Grazie 1, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Kiss B, Neagos CM, Jimborean G, Sárközi HK, Szathmary M, Neagos A. Comorbidities and Laryngeal Cancer in Patients with Obstructive Sleep Apnea: A Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1959. [PMID: 38004008 PMCID: PMC10672902 DOI: 10.3390/medicina59111959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/24/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023]
Abstract
Introductions: The global prevalence of obstructive sleep apnea shows that this disease appears in 1 billion people, with the prevalence exceeding 50% in some countries. Treatment is necessary to minimize negative health impacts. Obstructive sleep apnea (OSA) is defined as a cause of daytime sleepiness, as well as a clinical manifestation of sleep-disordered breathing. In the literature, there are numerous controversial studies regarding the etiology of this condition, but it is universally accepted that reduced activity in the upper airway muscles plays a significant role in its onset. Additionally, OSA has been associated with a series of comorbidities, such as type II diabetes, metabolic syndrome, and cardiovascular and pulmonary conditions, as well as head and neck tumors, especially oropharyngeal and laryngeal tumors. This is a review of the subject of OSA that considers several aspects: an analysis of the comorbidities associated with OSA, the involvement of tumor pathology in the onset of OSA, and the association of OSA with various types of laryngeal cancers. Additionally, it includes an evaluation of postoperative and medical outcomes for patients with OSA and laryngeal tumors treated surgically and medically, including chemotherapy. Relevant Sections: By taking into consideration the stated objective, a systematic analysis of the available literature was conducted, encompassing the PubMed, Medline, and Scopus databases. The evaluation was based on several keywords, including head and neck cancer, diabetes, diabetic, overlap syndrome, cardiovascular conditions, laryngeal neoplasm, radiotherapy, and chemotherapy, as well as the concept of quality of life in laryngectomized patients and patients with OSA. Discussions: The review evaluates the involvement of OSA in the presence of comorbidities, as well as the increased incidence of OSA in patients with laryngeal cancer. It is important to note that surgical and post-surgical treatment can play a significant role in triggering OSA in these patients. Conclusions: The studies regarding the correlations between OSA, comorbidities, and head and neck tumors indicate a significantly increased risk of OSA in association with conditions such as diabetes, metabolic syndrome, cardiovascular diseases, and head and neck tumors, particularly laryngeal tumors. This association has a physio-pathological basis. The various surgical methods followed by radiation and chemotherapy for tumor treatment do not exclude an increased risk of developing OSA after treatment. This significantly influences the quality of life of patients who survive these types of tumors. Future directions: Due to the multiple comorbidities associated with OSA, the extension of polysomnography associated with investigations during sleep, such as drug-induced sleep endoscopy, represents a tendency for the early diagnosis of this pathology, which affects the quality of life of these patients. Patients with head and neck cancer are at high risk of developing obstructive sleep apnea; this is why it is necessary to expand the polysomnographic investigation of these patients after surgical procedures or after radiotherapy and chemotherapy.
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Affiliation(s)
- Beata Kiss
- Department of Otorinolaryngology, Emergency County Hospital Targu Mures, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania (C.M.N.)
| | - Cristian Mircea Neagos
- Department of Otorinolaryngology, Emergency County Hospital Targu Mures, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania (C.M.N.)
| | - Gabriela Jimborean
- Pneumologic Department, George Emil Palade University of Medicine Science and Technology, 540136 Târgu Mures, Romania; (G.J.); (H.K.S.); (M.S.)
| | - Hédi Katalin Sárközi
- Pneumologic Department, George Emil Palade University of Medicine Science and Technology, 540136 Târgu Mures, Romania; (G.J.); (H.K.S.); (M.S.)
| | - Mioara Szathmary
- Pneumologic Department, George Emil Palade University of Medicine Science and Technology, 540136 Târgu Mures, Romania; (G.J.); (H.K.S.); (M.S.)
| | - Adriana Neagos
- Department of Otorinolaryngology, Emergency County Hospital Targu Mures, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania (C.M.N.)
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Zarogoulidis P, Petridis D, Kosmidis C, Sapalidis K, Nena L, Matthaios D, Porpodis K, Kakavelas P, Steiropoulos P. Immunotherapy and Chemotherapy Versus Sleep Disturbances for NSCLC Patients. Curr Oncol 2023; 30:1999-2006. [PMID: 36826116 PMCID: PMC9955782 DOI: 10.3390/curroncol30020155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/09/2023] Open
Abstract
INTRODUCTION Cancer patients are known to experience sleep disturbances that differ between disease stages and treatments. Regarding lung cancer patients and immunotherapy, information on their sleep disturbances has been recently acquired, but no comparison has been made between different treatment modalities. PATIENTS AND METHODS We recruited 98 non-small cell lung cancer patients; 49 had programmed death-ligand 1 expression of ≥50% and received immunotherapy as first-line treatment and 49 had programmed death-ligand 1 expression in the range from 0-49 and received chemotherapy as first-line treatment. All patients were stage IV, but with no bone metastasis. Sleep disturbances were recorded through polysomnography and sleep questionnaires. RESULTS For immunotherapy patients with PD-L1 expression ≥ 50%, the disease response was rapid and the sleep disturbances decreased rapidly. On the other hand, for chemotherapy patients, the sleep disturbances remained for all those patients that had partial response and stable disease. It was noticed that chemotherapy drugs induce severe adverse effects. DISCUSSION In our study, it was observed that patients with complete response had reduced sleep disturbances in the case of immunotherapy patients. However, sleep disturbances continued for several patients in the chemotherapy group due to the adverse effects of chemotherapy drugs. IN CONCLUSION Immunotherapy drugs on their own do not induce sleep disturbances and, through treatment response, alleviate sleep disturbances in lung cancer patients.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department, General Clinic Euromedica Private Hospital, 851 05 Thessaloniki, Greece
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6977-2719-74
| | - Dimitrios Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, 574 00 Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Lila Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
| | | | - Konstantinos Porpodis
- Pulmoanry Department, G. Papanikolaou General Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Paschalis Kakavelas
- Intensive Care Unit (ICU), General Clinic Euromedica, 153 43 Thessaloniki, Greece
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
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A Rare Kimura's Disease in the Oral Cavity with Severe Sleep Apnea: Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121810. [PMID: 36557012 PMCID: PMC9783615 DOI: 10.3390/medicina58121810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
Kimura's disease (KD) is a rare chronic inflammatory disorder that commonly occurs in Asian males. It mainly presents as painless subcutaneous masses or lymphadenopathy in the head and neck region. The incidence of KD in the oral cavity is quite rare. We reported a rare case of a 53-year-old male who had KD in his soft palate, hard palate and bilateral tonsils associated with severe sleep apnea. This patient underwent radiotherapy and exhibited a good response to the treatment. Throughout the 12-month follow-up period, the patient's condition remained satisfactory. Of the other 14 reviewed cases of KD in the oral cavity, the lesions can occur in the buccal mucosa, hard and soft palate, and mouth floor with specific clinical features. We further summarized their manifestations and treatments in order to guide the future identification and management of KD with lesions in the oral cavity.
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Du Y, Wu T. Heart failure and cancer: From active exposure to passive adaption. Front Cardiovasc Med 2022; 9:992011. [PMID: 36304546 PMCID: PMC9592839 DOI: 10.3389/fcvm.2022.992011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/20/2022] [Indexed: 12/06/2022] Open
Abstract
The human body seems like a "balance integrator." On the one hand, the body constantly actively receives various outside stimuli and signals to induce changes. On the other hand, several internal regulations would be initiated to adapt to these changes. In most cases, the body could keep the balance in vitro and in vivo to reach a healthy body. However, in some cases, the body can only get to a pathological balance. Actively exposed to unhealthy lifestyles and passively adapting to individual primary diseases lead to a similarly inner environment for both heart failure and cancer. To cope with these stimuli, the body must activate the system regulation mechanism and face the mutual interference. This review summarized the association between heart failure and cancer from active exposure to passive adaption. Moreover, we hope to inspire researchers to contemplate these two diseases from the angle of overall body consideration.
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Affiliation(s)
- Yantao Du
- Ningbo Institute of Medical Science, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China
| | - Tao Wu
- Department of Cardiovascular Center, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China,*Correspondence: Tao Wu,
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Money ME, Matthews CM, Tan-Shalaby J. Review of Under-Recognized Adjunctive Therapies for Cancer. Cancers (Basel) 2022; 14:4780. [PMID: 36230703 PMCID: PMC9563303 DOI: 10.3390/cancers14194780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/23/2022] [Accepted: 09/28/2022] [Indexed: 11/24/2022] Open
Abstract
Patients and providers may not be aware that several adjunctive measures can significantly improve the quality of life, response to treatment, and possibly outcomes for cancer patients. This manuscript presents a review of practical under-recognized adjunctive therapies that are effective including exercise; stress-reduction techniques such as mindfulness, massage, yoga, Tai Chi, breathing exercises; importance of sleep quality; diet modifications such as calorie restriction at the time of chemotherapy and avoidance of high carbohydrate foods; supplements such as aspirin, green tea, turmeric, and melatonin; and repurposed prescription medications such as metformin and statins. Each recommendation should be tailored to the individual patient to assure no contraindications.
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Affiliation(s)
- Mary E. Money
- Department of Medicine, University of Maryland School of Medicine, 665 W Baltimore Street S, Baltimore, MD 21201, USA
- Meritus Medical Center, 11116 Medical Campus Rd., Hagerstown, MD 21742, USA
| | - Carolyn M. Matthews
- Texas Oncology, PA and Charles A. Sammons Cancer Center, 3410 Worth St., Suite 400, Dallas, TX 75246, USA
- Gynecologic Oncology, Baylor Sammons Cancer Center, 3410 Worth St., Suite 400, Dallas, TX 75246, USA
| | - Jocelyn Tan-Shalaby
- Department of Medicine, University of Pittsburgh School of Medicine, 3550 Terrace St., Pittsburgh, PA 15213, USA
- Department of Medicine, Veteran Affairs Pittsburgh Healthcare System, 4100 Allequippa St., Pittsburgh, PA 15240, USA
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