학술논문

Polysomnographic Markers of Obstructive Sleep Apnea Severity and Cancer-related Mortality: A Large Retrospective Multicenter Clinical Cohort Study.
Document Type
article
Source
Annals of the American Thoracic Society. 19(5)
Subject
Biomedical and Clinical Sciences
Cardiovascular Medicine and Haematology
Lung
Sleep Research
Prevention
Clinical Research
Cancer
Good Health and Well Being
Adult
Biomarkers
Cohort Studies
Humans
Hypoxia
Incidence
Neoplasms
Ontario
Retrospective Studies
Risk Factors
Severity of Illness Index
Sleep Apnea
Obstructive
Sleep Deprivation
sleep apnea
obstructive
neoplasms
adult
mortality
Cardiovascular medicine and haematology
Clinical sciences
Language
Abstract
Rationale: The evidence for an association between cancer survival and obstructive sleep apnea (OSA) remains underexplored. Objectives: To evaluate an association between markers of OSA severity (respiratory disturbances, hypoxemia, and sleep fragmentation) and cancer-related mortality in individuals with previously diagnosed cancer. Methods: We conducted a multicenter retrospective cohort study using linked clinical and provincial health administrative data on consecutive adults who underwent a diagnostic sleep study between 1994 and 2017 in four Canadian academic hospitals and were previously diagnosed with cancer through the Ontario Cancer Registry. Multivariable cause-specific Cox regressions were used to address the research objective. Results: We included 2,222 subjects. Over a median follow-up time of 5.6 years (interquartile range [IQR], 2.7-9.1 years), 261/2,222 (11.7%) individuals with prevalent cancer died from cancer-related causes, which accounted for 44.2% (261/590) of all-cause death. Controlling for age, sex, alcohol use disorder, prior heart failure, chronic obstructive pulmonary disease, hypertension, diabetes, treatment for OSA, clinic site, year of the sleep study, and time since the cancer diagnosis, measures of hypoxemia and sleep fragmentation, but not apnea-hypopnea index, were significantly associated with the cancer-specific mortality: percentage of time spent with arterial oxygen saturation (SaO2)