Treatment of obstructive sleep apnea with CPAP improves daytime sleepiness and fatigue in cancer patients

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-10-30 DOI:10.1002/cam4.7198

Kimia G. Ganjaei, Karen A. Wong, Shiela M. Strauss, Sigrid V. Carlsson, Margaret Barton-Burke, Miranda Tan

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Abstract

Background

Fatigue and sleep disorders are prevalent in cancer patients. Obstructive sleep apnea (OSA) commonly causes excessive daytime sleepiness (EDS) and fatigue. We hypothesize that treating cancer patients with OSA using positive airway pressure (PAP) will improve EDS and fatigue.

Methods

A retrospective chart review of sleep clinic visits of cancer patients with newly diagnosed OSA was performed. Epworth Sleepiness Scale (ESS) and fatigue reported at baseline and within 6 months of starting PAP therapy were compared between PAP-adherent and PAP-non-adherent patients.

Results

65 cancer patients with OSA and ESS >10 were recommended PAP therapy, including 45 patients with fatigue. 29 patients pursued PAP therapy with 79% (n = 23) adherent at follow-up. The median baseline apnea hypopnea index (AHI) for OSA was 24.0 (interquartile range [IQR] 14.3, 32.3) and 23.8 (IQR 10.1, 42.8) events/hour among PAP-adherent and PAP-non-adherent patients, respectively (p = 0.90). Median baseline ESS was 14.0 (IQR 12.0, 17.0) among adherent and 17.0 (IQR 11.0, 17.3) among non-adherent patients (p = 0.73). The median ESS at follow-up of the adherent and non-adherent groups was 8.0 (IQR 6.0, 10.0) and 11.0 (IQR 8.0, 15.8), respectively (p = 0.08). Median ESS change was −5.0 (IQR −7.0, −4.0) in PAP adherent patients and −2.5 (IQR −5.25, −1.50) in PAP-non-adherent patients (p = 0.07). When the groups are examined separately, the median change in the PAP-adherent group was highly significant (p = 0.001), while the ESS median change in the PAP-non-adherent group was considerably less (p = 0.04). 17 out of the 21 PAP-adherent patients reporting fatigue at baseline indicated improvement at follow-up.

Conclusions

PAP therapy for OSA in cancer patients improves EDS and fatigue. Larger studies are necessary to evaluate the efficacy of PAP in improving fatigue in this population.

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使用 CPAP 治疗阻塞性睡眠呼吸暂停可改善癌症患者的白天嗜睡和疲劳。

背景：癌症患者普遍存在疲劳和睡眠障碍。阻塞性睡眠呼吸暂停（OSA）通常会导致白天过度嗜睡（EDS）和疲劳。我们假设，使用气道正压（PAP）治疗患有 OSA 的癌症患者将改善 EDS 和疲劳：方法：我们对新诊断为 OSA 的癌症患者的睡眠门诊就诊情况进行了回顾性病历审查。结果：65 名伴有 OSA 和 EDS 的癌症患者在开始使用气道压力治疗后 6 个月内的 EDS 和疲劳情况进行了比较：结果：65 名患有 OSA 且 ESS >10 的癌症患者被推荐接受 PAP 治疗，其中 45 名患者有疲劳症状。29 名患者接受了呼吸机治疗，其中 79% 的患者（n = 23）在随访时坚持了呼吸机治疗。在坚持使用呼吸机治疗和未坚持使用呼吸机治疗的患者中，OSA 的基线呼吸暂停低通气指数（AHI）中位数分别为 24.0（四分位数间距 [IQR] 14.3，32.3）和 23.8（IQR 10.1，42.8）次/小时（P = 0.90）。依从患者的基线 ESS 中位数为 14.0（IQR 12.0，17.0），非依从患者的基线 ESS 中位数为 17.0（IQR 11.0，17.3）（p = 0.73）。坚持治疗组和未坚持治疗组的随访ESS中位数分别为8.0（IQR 6.0，10.0）和11.0（IQR 8.0，15.8）（p = 0.08）。PAP依从性患者的ESS变化中位数为-5.0（IQR -7.0，-4.0），PAP非依从性患者的ESS变化中位数为-2.5（IQR -5.25，-1.50）（p = 0.07）。如果将两组患者分开来看，坚持使用血压计组患者的中位数变化非常显著（p = 0.001），而不坚持使用血压计组患者的 ESS 中位数变化则要小得多（p = 0.04）。在 21 名坚持使用呼吸机治疗的患者中，有 17 名在基线时报告有疲劳症状，但在随访时症状有所改善：结论：PAP 治疗癌症患者的 OSA 可改善 EDS 和疲劳。有必要进行更大规模的研究，以评估 PAP 在改善该人群疲劳方面的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.