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Are upper airways resistance syndrome and obstructive sleep apnea a side-effect of oral cancer therapy?

S.P. Tandon, A. Khutarkar, S. Ansari, M. Khale, S.K. Rajan, J. Deodhar, J.P. Agarwal, P. Chaturvedi, P. Pai, D. Chaukar, R. Havaldar, S. Laskar, P. Yadav, A.K. D'Cruz
European Respiratory Journal 2011 38: p3468; DOI:
S.P. Tandon
1Pulmonary Medical Unit, Tata Memorial Hospital, Mumbai, India
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A. Khutarkar
1Pulmonary Medical Unit, Tata Memorial Hospital, Mumbai, India
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S. Ansari
1Pulmonary Medical Unit, Tata Memorial Hospital, Mumbai, India
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M. Khale
1Pulmonary Medical Unit, Tata Memorial Hospital, Mumbai, India
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S.K. Rajan
2Respiratory Medicine, Bombay Hospital, Mumbai, India
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J. Deodhar
3Psychiatric Unit, Tata Memorial Hospital, Mumbai, India
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J.P. Agarwal
4Radiation Oncology, Tata Memorial Hospital, Mumbai, India
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P. Chaturvedi
5Head and Neck Surgical Oncology Unit, Tata Memorial Hospital, Mumbai, India
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P. Pai
5Head and Neck Surgical Oncology Unit, Tata Memorial Hospital, Mumbai, India
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D. Chaukar
5Head and Neck Surgical Oncology Unit, Tata Memorial Hospital, Mumbai, India
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R. Havaldar
6Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, India
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S. Laskar
4Radiation Oncology, Tata Memorial Hospital, Mumbai, India
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P. Yadav
7Plastic, Reconstructive and Microvascular Unit, Tata Memorial Hospital, Mumbai, India
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A.K. D'Cruz
5Head and Neck Surgical Oncology Unit, Tata Memorial Hospital, Mumbai, India
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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
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Are upper airways resistance syndrome and obstructive sleep apnea a side-effect of oral cancer therapy?
S.P. Tandon, A. Khutarkar, S. Ansari, M. Khale, S.K. Rajan, J. Deodhar, J.P. Agarwal, P. Chaturvedi, P. Pai, D. Chaukar, R. Havaldar, S. Laskar, P. Yadav, A.K. D'Cruz
European Respiratory Journal Sep 2011, 38 (Suppl 55) p3468;

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Are upper airways resistance syndrome and obstructive sleep apnea a side-effect of oral cancer therapy?
S.P. Tandon, A. Khutarkar, S. Ansari, M. Khale, S.K. Rajan, J. Deodhar, J.P. Agarwal, P. Chaturvedi, P. Pai, D. Chaukar, R. Havaldar, S. Laskar, P. Yadav, A.K. D'Cruz
European Respiratory Journal Sep 2011, 38 (Suppl 55) p3468;
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