Sleep Apnea Linked to Higher Cancer Death Risk

SUNDAY, May 20 (HealthDay News) — Sleep apnea has already been
linked to a host of adverse health problems, such as high blood pressure
and heart disease. Now, new research suggests that in people who already
have cancer, the sleep disorder may raise their risk of dying from
cancer.

People with the most severe sleep apnea — those who have 30 or more
episodes of low or no oxygen in an hour of sleep — had almost five times
the risk of cancer death compared to someone without sleep apnea.

“Sleep apnea is the periodic pausing of breathing during sleep that
results in drops in oxygen levels in your blood. It causes snoring and
sleepiness during the day,” explained study author Dr. Javier Nieto, chair
of the department of population health sciences at the University of
Wisconsin School of Medicine and Public Health, in Madison.

“Aside from being an annoyance to your spouse, family members and maybe
even your neighbors depending on how loud your snoring is, sleep apnea is
a severe problem. Drowsiness and sleepiness during the day increase the
risk of accidents, and sleep apnea is associated with cardiovascular
disease, heart disease, strokes, hypertension and cardiovascular
mortality. Now, we see this new angle: an increase in cancer mortality,”
said Nieto.

Nieto is scheduled to present the study Sunday at the American Thoracic
Society International Conference, in San Francisco.

Nieto said the new study was suggested by researchers from the
University of Barcelona in Spain who found that when mice were deprived of
oxygen periodically, skin cancer tumors grew faster in the mice. And,
cancer cells in the lab that are deprived of oxygen produce molecules that
stimulate the growth of blood vessels in an attempt to get more oxygen, he
said.

Nieto and the Spanish researchers wondered if this effect was the same
in humans. To test that theory, they reviewed data from more than 1,500
people included in the Wisconsin Sleep Cohort. This study included 22
years of mortality data, as well as information from sleep studies.

The researchers adjusted the data to account for age, sex, body mass,
smoking and other factors that might affect the risk of cancer death, and
they found that sleep apnea increased the risk of cancer death. They also
found that the more severe the sleep apnea, the more likely someone was to
die from cancer.

People with mild sleep apnea — five to 14.9 episodes of low or no
oxygen in an hour — had a 10 percent increased risk of cancer death,
while those with moderate sleep apnea — 15 to 29.9 episodes of low or no
oxygen in an hour — had double the risk of cancer death. Those with
severe sleep apnea — more than 30 episodes of low or no oxygen in an
hour — had a 4.8 times higher risk of cancer death.

Nieto said the study didn’t prove a cause-and-effect relationship, but
the association was quite strong. And, he noted that the findings were
consistent in humans, animals and in cells.

He added that there is also a plausible mechanism for this association.
When you have cancer and you repeatedly have episodes of low or no oxygen,
the cancer cells “try to compensate for the lack of oxygen by growing
additional blood vessels to get more oxygen. It’s a defense mechanism,”
Nieto said. And, as those blood vessels keep growing, it helps the tumor
to spread, he explained.

Dr. Steven Park, a sleep medicine specialist and otorhinolaryngologist
at Montefiore Medical Center in New York City, said he wasn’t surprised by
the findings.

“This goes along with the link between sleep apnea and pretty much
every chronic medical condition out there,” Park said. But, he added that
this study’s findings need to be confirmed in other studies, and ideally
be published in a peer-reviewed journal. Research presented at medical
meetings should be viewed as preliminary until published in a
peer-reviewed medical journal.

“Anyone with snoring, severe daytime fatigue, lack of memory or focus,
high blood pressure, diabetes, and even someone who has to get up to go to
the bathroom at night should be screened for sleep apnea,” Park said. He
added that it’s possible to have sleep apnea without snoring, especially
for women. So, if you’re getting enough sleep at night, yet still feel
tired during the day, it’s important to bring this up to your doctor.

Park said there are home-monitoring devices that can be used to screen
people at home initially.

Nieto said that treating sleep apnea will improve your quality of life,
as well as reduce your risk of high blood pressure and cardiovascular
disease. And, if you have cancer, he said, treating sleep apnea may help
increase your odds of surviving cancer.

More information

Learn more about sleep apnea from the U.S. National Heart, Lung and Blood Institute.

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