Several studies have indicated an in – creased prevalence of obstructive sleep apnea (OSA) in patients with lung cancer, despite ongoing debate surrounding the precise association between these conditions. In a study published in Respiratory Research, Mohamed H. Zidan and colleagues sought to explore the predictors of moderate-to-severe OSA in this patient population.
The comprehensive study included 153 adult patients newly diagnosed with lung cancer from March 2021 to December 2022. Using home sleep apnea devices, the study group underwent cardiorespiratory monitoring so researchers could assess OSA severity. Through univariate and multivariate logistic regression analyses, the investigators evaluated various parameters, including age, gender, smoking status, neck circumference, waist circumference, BMI, lung cancer stage and histopathology, presence of superior vena cava obstruction, and performance status.
Poor performance status emerged as the most significant predictor of moderate-to-severe OSA among patients with lung cancer, even after the researchers accounted for important confounding variables.
“Performance status is expected to be poor in patients with symptomatic lung cancer. This can be caused by cancer itself or any associated disease. This poor performance status will affect the choice of management plan for these patients,” Zidan and colleagues reported. “To the best of our knowledge, performance status in patients with comorbid OSA and lung cancer was not reported in previous studies.”
The study was limited by its relatively small sample size, lack of healthy controls, and lack of patients with early-stage cancer. Nevertheless, the researchers emphasized the importance of considering performance status as a potential indicator of OSA severity in lung cancer management.
Zidan and colleagues wrote that the need for OSA screening is “particularly relevant in patients with advanced malignancy who will have lost weight due to the catabolic state of advanced malignancy, and thus may not fulfill the usual BMI bracket of typical patients with OSA.”
“Early detection of comorbid conditions that can worsen performance status, and hence lead to poorer outcomes, is a clinical priority. As treatment of patients with OSA is reported to improve their sleep quality, performance status, and QOL, it is important to offer the best treatment options for OSA,” the researchers concluded.