OSA common in patients undergoing lung cancer screening

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Takeaway

  • Obstructive sleep apnea (OSA) was found in more than three-quarters of a high-risk population enrolled in a lung cancer screening program. 
  • Patients with significant nocturnal hypoxemia were more than twice as likely to have a positive lung cancer screening.

Why this matters

  • There were no studies on sleep-disordered breathing in patients undergoing lung cancer screening, although animal studies had shown an association between nocturnal hypoxemia and lung cancer.

Study design

  • 236 patients in the SAILS prospective trial underwent low-dose CT lung cancer screening and home sleep apnea testing.
  • Nocturnal hypoxemia defined as the percentage of sleep time spent with an oxyhemoglobin saturation
  • Funding: None disclosed.

Key results

  • Lung cancer prevalence at baseline was 1.3%.
  • 62.1% had COPD and 74.2% had emphysema.
  • 77.5% had OSA (36.4% mild, 23.3% moderate, 17.8% severe).
  • Mean T90 was 4.60 and mean apnea-hypopnea index (AHI) was 16.60.
  • After multivariable analysis, snoring was associated with AHI stratified by OSA (aOR, 5.78; P=.001).
  • Patients with significant nocturnal hypoxemia (T90 >12%) were more likely to have a positive lung cancer screening, after adjusting for possible confounders (aOR, 2.6; P=.027).

Limitations

  • Single-center study with no control group.