Abstract
Background: Reconstructive surgery and radiotherapy cause changes in airway calibre and tone which may lead to Upper Airways Resistance Syndrome (UARS) and Obstructive Sleep Apnea (OSA). We aimed to study the prevalence of UARS and OSA in treated Oral Cancer patients.
Methodology: 78 patients (69 males, 9 females, mean age 49 years) treated for Oral Cancer were administered the Epworth Sleepiness Scale (ESS). Patients' perception of sleep quality (SLq) and mental health status were noted from Mental Health and Quality of Life Questionnaires (GHQ28, EORTC QLQ-C30 (V03), QLQ-H&N35) and all underwent Polysomnography. They were categorised on the basis of Respiratory Disturbance Index (RDI) {i.e.Apnea-Hypopnea Index (AHI) with Respiratory Effort Related Arousals (RERAs)} into Normal (RDI<5/h), UARS (RDI 5-15/h), OSA (RDI>15/h) and Sleep Disordered Breathing (SDB) where (SDB=UARS+OSA: RDI>5/h).
Results: 66 patients underwent surgery with adjuvant (chemo)radiation and remaining 12 (chemo)radiation.SDB defined by RDI was present in 70.5% as compared to 29.5% defined by AHI. 48.7% had UARS and 21.8% had OSA.SLq was significantly associated with high GHQ28 scores (p=0.002) and SDB (p=0.04).
Conclusions: Upper Airways Resistance Syndrome and Obstructive Sleep Apnea are a common yet unrecognised problem in treated Oral Cancer patients.Apnea-Hypopnea Index underestimated SDB,UARS and OSA significantly (29.5%,24.4% and 5.1% respectively)with a higher prevalence (70.5%,48.7% and 21.8%) as per the Respiratory Disturbance Index which included Respiratory Effort Related Arousals.Poor mental health is associated with disturbed sleep in these patients,but Sleep Disordered Breathing may also be a contributing factor.
- © 2011 ERS
