The occurrence of sleep-disordered breathing among patients with head and neck cancer.

OBJECTIVE To identify the incidence of obstructive sleep apnea (OSA) in patients treated for head and neck cancer. Obstructive sleep apnea is a relatively common and highly morbid condition that affects 9.1% of male and 4% of female middle-aged adults.1 Patients who have been successfully treated for head and neck cancer may often have a partially obstructed upper airway which is functional during the day, but collapses during sleep. STUDY DESIGN/METHODS Twenty-four patients successfully treated for tumors of the tongue-base, pharynx, or supraglottic larynx were enrolled. Through OSA-related questionnaires, physical examination, and polysomnography, the incidence of OSA in this patient population was determined and compared with that of the general population. RESULTS The incidence of OSA (91.7%) in this head and neck cancer patient population was found to be significantly (P =.001) higher than that of the general population. (In a random sampling of middle-aged adult males between the ages of 30 and 60 years old with a respiratory disturbance index (RDI) >15, the prevalence was previously reported to be 9.1%.1) Sixteen of 24 patients (72.7%) had clinically defined symptoms of sleep apnea. Ten of 24 patients (41.7%) received radiation therapy; all had an RDI >15. Eleven of the 14 patients (78.5%) who did not receive radiation therapy also had an RDI >15. Eight patients (33.3%) continue to regularly use continuous positive airway pressure with significant improvement in symptoms. CONCLUSIONS Identification and treatment of OSA may be an important factor in improving quality of life for patients with head and neck cancer.