Department of Public Health, University of Copenhagen, Copenhagen, Denmark ; Copenhagen Stress Research Center, Copenhagen, Denmark.
Sleep. 2013 Oct 1;36(10):1429-35. doi: 10.5665/sleep.3030.
Sleep disordered breathing (SDB) has been associated with oxidative stress, inflammation, and altered hormonal levels, all of which could affect the risk of cancer. The aim of the study is to examine if symptoms of SDB including snoring, breathing cessations, and daytime sleepiness affect the incidence of total cancer and subtypes of cancer.
Prospective cohort study.
The third wave (1991-1993) of the Copenhagen City Heart Study.
There were 8,783 men and women in whom cancer had not been previously diagnosed.
Participants answered questions about snoring and breathing cessations in 1991-1993, whereas information about daytime sleepiness based on the Epworth Sleepiness Scale was collected in a subset of the participants (n = 5,894) in 1998. First-time incidence of cancer was followed until December 2009 in a nationwide cancer register. We found no overall association between symptoms of SDB and incident cancer. Yet, in the small group with high daytime sleepiness, we observed a surprisingly higher cancer incidence (hazard ratio = 4.09; 95% CI 1.58-10.55) in persons younger than 50 years. We also found a higher risk of virus/immune-related cancers (2.73; 1.27-5.91) and alcohol-related cancers (4.92; 1.45-16.76) among persons with daytime sleepiness. More SDB symptoms were associated with a higher risk of smoking-related cancers (Ptrend: 0.04). Apart from these findings there were no clear associations between symptoms of sleep disordered breathing and cancer subtypes.
We found very limited evidence of relationship between symptoms of sleep disordered breathing and incidence of cancer.
睡眠呼吸障碍（SDB）与氧化应激、炎症和激素水平改变有关，所有这些都可能影响癌症的风险。本研究的目的是研究 SDB 症状（包括打鼾、呼吸暂停和白天嗜睡）是否会影响总癌症和癌症亚型的发病率。
前瞻性队列研究。
哥本哈根城市心脏研究第三波（1991-1993 年）。
共有 8783 名男女参与者，他们之前未被诊断出患有癌症。
参与者在 1991-1993 年回答了关于打鼾和呼吸暂停的问题，而基于 Epworth 嗜睡量表的白天嗜睡信息则在参与者的一部分（n=5894）中收集1998 年。癌症的首次发病情况在全国癌症登记处进行了随访，直至 2009 年 12 月。我们没有发现 SDB 症状与癌症发病之间存在总体关联。然而，在年轻于 50 岁的嗜睡小群体中，我们观察到令人惊讶的更高的癌症发病率（风险比=4.09；95%CI 1.58-10.55）。我们还发现白天嗜睡的人患病毒/免疫相关癌症的风险更高（2.73；1.27-5.91）和酒精相关癌症（4.92；1.45-16.76）。更多的 SDB 症状与吸烟相关癌症的风险增加相关（趋势：0.04）。除了这些发现，SDB 症状与癌症亚型之间没有明显的关联。
我们发现 SDB 症状与癌症发病率之间的关系非常有限。
