Screening for obstructive sleep apnoea in post‐treatment cancer patients

Abstract

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.

Keywords

• breast cancer
• cancer outcomes
• endometrial cancer
• melanoma
• screening
• sleep apnea