Screening for obstructive sleep apnoea in post‐treatment cancer patients

Abstract Background and aims For cancer patients, comorbid obstructive sleep apnea (OSA) poses additional risk to their surgical/anaesthetic outcomes, quality of life, and survival. However, OSA screening is not well‐established in oncology settings. We tested two screening tools (STOP‐Bang question...

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Main Authors: Harini Subramanian, Veronika Fuchsova, Elisabeth Elder, Alison Brand, Julie Howle, Anna DeFazio, Graham J. Mann, Terence Amis, Kristina Kairaitis
Format: Article
Language:English
Published: Wiley 2023-03-01
Series:Cancer Reports
Subjects:
Online Access:https://doi.org/10.1002/cnr2.1740
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author Harini Subramanian
Veronika Fuchsova
Elisabeth Elder
Alison Brand
Julie Howle
Anna DeFazio
Graham J. Mann
Terence Amis
Kristina Kairaitis
author_facet Harini Subramanian
Veronika Fuchsova
Elisabeth Elder
Alison Brand
Julie Howle
Anna DeFazio
Graham J. Mann
Terence Amis
Kristina Kairaitis
author_sort Harini Subramanian
collection DOAJ
description Abstract Background and aims For cancer patients, comorbid obstructive sleep apnea (OSA) poses additional risk to their surgical/anaesthetic outcomes, quality of life, and survival. However, OSA screening is not well‐established in oncology settings. We tested two screening tools (STOP‐Bang questionnaire [SBQ] and the at‐home monitoring device, ApneaLink™Air), for predicting polysomnography (PSG) confirmed OSA in post‐treatment cancer patients. Methods Breast (n = 56), endometrial (n = 37) and melanoma patients (n = 50) were recruited from follow‐up clinics at Westmead Hospital (Sydney, Australia). All underwent overnight PSG, 137 completed SBQ, and 99 completed ApneaLink™Air. Positive (PPV) and negative (NPV) predictive values for PSG‐determined moderate‐to‐severe OSA and severe OSA, were calculated using an SBQ threshold ≥3 au and ApneaLink™Air apnoea‐hypopnea index thresholds of ≥10, ≥15 and ≥30 events/h. Results Both SBQ and ApneaLink™Air had high NPVs (92.7% and 85.2%–95.6% respectively) for severe OSA, but NPVs were lower for moderate‐to‐severe OSA (69.1% and 59.1%–75.5%, respectively). PPV for both tools were relatively low (all <73%). Combining both tools did not improve screening performance. Conclusions These screening tools may help identify cancer patients without severe OSA, but both are limited in identifying those with moderate‐to‐severe or severe OSA. PSG remains optimal for adequately identifying and managing comorbid OSA in cancer patients.
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spelling doaj.art-95406cde5b55473e9b675e962dc9a5e42023-03-20T11:07:47ZengWileyCancer Reports2573-83482023-03-0163n/an/a10.1002/cnr2.1740Screening for obstructive sleep apnoea in post‐treatment cancer patientsHarini Subramanian0Veronika Fuchsova1Elisabeth Elder2Alison Brand3Julie Howle4Anna DeFazio5Graham J. Mann6Terence Amis7Kristina Kairaitis8Ludwig Engel Centre for Respiratory Research The Westmead Institute for Medical Research Westmead AustraliaLudwig Engel Centre for Respiratory Research The Westmead Institute for Medical Research Westmead AustraliaWestmead Clinical School, Faculty of Medicine and Health The University of Sydney Westmead AustraliaWestmead Clinical School, Faculty of Medicine and Health The University of Sydney Westmead AustraliaWestmead Clinical School, Faculty of Medicine and Health The University of Sydney Westmead AustraliaDepartment of Gynaecological Oncology Westmead Hospital Westmead AustraliaMelanoma Institute Australia The University of Sydney Camperdown AustraliaLudwig Engel Centre for Respiratory Research The Westmead Institute for Medical Research Westmead AustraliaLudwig Engel Centre for Respiratory Research The Westmead Institute for Medical Research Westmead AustraliaAbstract Background and aims For cancer patients, comorbid obstructive sleep apnea (OSA) poses additional risk to their surgical/anaesthetic outcomes, quality of life, and survival. However, OSA screening is not well‐established in oncology settings. We tested two screening tools (STOP‐Bang questionnaire [SBQ] and the at‐home monitoring device, ApneaLink™Air), for predicting polysomnography (PSG) confirmed OSA in post‐treatment cancer patients. Methods Breast (n = 56), endometrial (n = 37) and melanoma patients (n = 50) were recruited from follow‐up clinics at Westmead Hospital (Sydney, Australia). All underwent overnight PSG, 137 completed SBQ, and 99 completed ApneaLink™Air. Positive (PPV) and negative (NPV) predictive values for PSG‐determined moderate‐to‐severe OSA and severe OSA, were calculated using an SBQ threshold ≥3 au and ApneaLink™Air apnoea‐hypopnea index thresholds of ≥10, ≥15 and ≥30 events/h. Results Both SBQ and ApneaLink™Air had high NPVs (92.7% and 85.2%–95.6% respectively) for severe OSA, but NPVs were lower for moderate‐to‐severe OSA (69.1% and 59.1%–75.5%, respectively). PPV for both tools were relatively low (all <73%). Combining both tools did not improve screening performance. Conclusions These screening tools may help identify cancer patients without severe OSA, but both are limited in identifying those with moderate‐to‐severe or severe OSA. PSG remains optimal for adequately identifying and managing comorbid OSA in cancer patients.https://doi.org/10.1002/cnr2.1740breast cancercancer outcomesendometrial cancermelanomascreeningsleep apnea
spellingShingle Harini Subramanian
Veronika Fuchsova
Elisabeth Elder
Alison Brand
Julie Howle
Anna DeFazio
Graham J. Mann
Terence Amis
Kristina Kairaitis
Screening for obstructive sleep apnoea in post‐treatment cancer patients
Cancer Reports
breast cancer
cancer outcomes
endometrial cancer
melanoma
screening
sleep apnea
title Screening for obstructive sleep apnoea in post‐treatment cancer patients
title_full Screening for obstructive sleep apnoea in post‐treatment cancer patients
title_fullStr Screening for obstructive sleep apnoea in post‐treatment cancer patients
title_full_unstemmed Screening for obstructive sleep apnoea in post‐treatment cancer patients
title_short Screening for obstructive sleep apnoea in post‐treatment cancer patients
title_sort screening for obstructive sleep apnoea in post treatment cancer patients
topic breast cancer
cancer outcomes
endometrial cancer
melanoma
screening
sleep apnea
url https://doi.org/10.1002/cnr2.1740
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