Pulmonary Department, Clínica Universidad de Navarra, Madrid, Spain.
Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain.
Sleep Med. 2019 Feb;54:181-186. doi: 10.1016/j.sleep.2018.10.020. Epub 2018 Nov 3.
Obstructive sleep apnea (OSA) can influence the appearance and proliferation of some tumors. The Sleep Apnea In Lung Cancer Screening (SAILS) study (NCT02764866) evaluated the prevalence of OSA and nocturnal hypoxemia in a high-risk population enrolled in a lung cancer screening program.
This was a prospective study of the prevalence of OSA in a lung cancer screening program. Subjects met the National Lung Screening Trial (NLST) age and smoking criteria (age 55-75 years; pack-years >30). Participants in the study were offered annual screening with low-dose computed tomography (LDCT) and pulmonary function testing, as well as home sleep apnea testing (HSAT) and a sleep-specific questionnaire. Sleep study-related variables, symptoms, and epidemiologic data were recorded.
HSAT was offered to 279 subjects enrolled in our lung cancer screening program. HSAT results were available for 236 participants (mean age 63.6 years; mean tobacco exposure: 45 pack-years), of whom 59% were male and 53% were active smokers. Emphysema (74%) and chronic obstructive pulmonary disease (COPD) (62%) were common and in most cases mild in severity. OSA, including moderate to severe disease, was very common in this patient population. AHI distributions were as follows: AHI <5 (22.5%); 5-15 (36.4%); 15-30 (23.3%); and >30 (17.8%). Nocturnal hypoxemia (T90) (p = 0.003), diffusing capacity for carbon monoxide (DLCO) (p = 0.01), tobacco exposure (p = 0.024), and COPD (p = 0.023) were associated with OSA severity. Positive screening findings (nodules ≥6 mm) were associated with nocturnal hypoxemia on multivariate analysis adjusted for confounders (OR = 2.6, 95% CI = 1.12-6.09, p = 0.027).
Moderate to severe OSA is very prevalent in patients enrolled in a lung cancer screening program. Nocturnal hypoxemia more than doubles the risk of positive screening findings.
阻塞性睡眠呼吸暂停(OSA)会影响某些肿瘤的外观和增殖。睡眠呼吸暂停与肺癌筛查研究(SAILS)(NCT02764866)评估了纳入肺癌筛查计划的高危人群中 OSA 和夜间低氧血症的患病率。
这是一项关于肺癌筛查计划中 OSA 患病率的前瞻性研究。研究对象符合国家肺癌筛查试验(NLST)的年龄和吸烟标准(年龄 55-75 岁;吸烟量 >30 包年)。研究中的参与者接受了每年一次的低剂量计算机断层扫描(LDCT)和肺功能测试,以及家庭睡眠呼吸暂停测试(HSAT)和睡眠特定问卷。记录了睡眠研究相关变量、症状和流行病学数据。
HSAT 提供给了我们肺癌筛查计划中 279 名入组者。HSAT 结果可用于 236 名参与者(平均年龄 63.6 岁;平均烟草暴露量:45 包年),其中 59%为男性,53%为活跃吸烟者。肺气肿(74%)和慢性阻塞性肺疾病(COPD)(62%)很常见,且在大多数情况下病情较轻。在这个患者群体中,OSA,包括中重度疾病,非常常见。AHI 分布如下:AHI<5(22.5%);5-15(36.4%);15-30(23.3%);和>30(17.8%)。夜间低氧血症(T90)(p=0.003)、一氧化碳弥散量(DLCO)(p=0.01)、烟草暴露(p=0.024)和 COPD(p=0.023)与 OSA 严重程度相关。多变量分析调整混杂因素后,阳性筛查结果(结节≥6mm)与夜间低氧血症相关(OR=2.6,95%CI=1.12-6.09,p=0.027)。
在纳入肺癌筛查计划的患者中,中重度 OSA 非常普遍。夜间低氧血症使阳性筛查结果的风险增加两倍以上。