Relationship Between Sleep Apnea and Cancer.

In the light of relationships reported between hypoxemia (tissue hypoxia) and cancer, Abrams et al. concluded in 2008 that sleep apnea-hypopnea syndrome (SAHS) and its main consequence, intermittent hypoxia, could be related with increased susceptibility to cancer or poorer prognosis of a pre-existing tumor. This pathophysiological association was confirmed in animal studies. Two large independent historical cohort studies subsequently found that the degree of nocturnal hypoxia in patients with SAHS was associated with higher cancer incidence and mortality. This finding has been confirmed in almost all subsequent studies, although the retrospective nature of some requires that they be considered as hypothesis-generating only. The relationship between sleep apnea and cancer, and the pathophysiological mechanisms governing it, could be clarified in the near future in a currently on-going study in a large group of melanoma patients.

[1]  D. Navajas,et al.  Intermittent hypoxia increases melanoma metastasis to the lung in a mouse model of sleep apnea , 2013, Respiratory Physiology & Neurobiology.

[2]  J. Gu,et al.  Obesity promotes melanoma tumor growth: Role of leptin , 2009, Cancer biology & therapy.

[3]  Ronald R Grunstein,et al.  Sleep apnea and 20-year follow-up for all-cause mortality, stroke, and cancer incidence and mortality in the Busselton Health Study cohort. , 2014, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[4]  D. Gozal,et al.  Circulating vascular endothelial growth factor levels in patients with obstructive sleep apnea. , 2002, Sleep.

[5]  K. A. Zanin,et al.  Sleep Deprivation Increases Mortality in Female Mice Bearing Ehrlich Ascitic Tumor , 2013, Neuroimmunomodulation.

[6]  E. Schernhammer,et al.  A prospective study on habitual duration of sleep and incidence of breast cancer in a large cohort of women. , 2006, Cancer research.

[7]  S. Ancoli-Israel,et al.  Diurnal variability of C-reactive protein in obstructive sleep apnea , 2009, Sleep and Breathing.

[8]  V. Kapur,et al.  Emerging from the shadows: a possible link between sleep apnea and cancer. , 2014, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[9]  K. Flegal,et al.  Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories , 2012 .

[10]  D. Gozal,et al.  Fragmented sleep accelerates tumor growth and progression through recruitment of tumor-associated macrophages and TLR4 signaling. , 2014, Cancer research.

[11]  G. Sethi,et al.  Multifaceted link between cancer and inflammation. , 2012, Bioscience reports.

[12]  D. Gozal,et al.  Sleep fragmentation in mice induces nicotinamide adenine dinucleotide phosphate oxidase 2-dependent mobilization, proliferation, and differentiation of adipocyte progenitors in visceral white adipose tissue. , 2014, Sleep.

[13]  J. Montserrat,et al.  Cardiovascular mortality in obstructive sleep apnea in the elderly: role of long-term continuous positive airway pressure treatment: a prospective observational study. , 2012, American journal of respiratory and critical care medicine.

[14]  R. Farré,et al.  Association between obstructive sleep apnea and cancer incidence in a large multicenter Spanish cohort. , 2013, American journal of respiratory and critical care medicine.

[15]  L. Sobrinho,et al.  Serum vascular endothelial growth factor levels in patients with medullary thyroid carcinoma. , 2008, European journal of endocrinology.

[16]  R. Farré,et al.  Obstructive sleep apnea is associated with cancer mortality in younger patients. , 2014, Sleep medicine.

[17]  J. Davis,et al.  Influence of chronic moderate sleep restriction and exercise on inflammation and carcinogenesis in mice , 2012, Brain, Behavior, and Immunity.

[18]  D. Navajas,et al.  Obesity and intermittent hypoxia increase tumor growth in a mouse model of sleep apnea. , 2012, Sleep medicine.

[19]  John Condeelis,et al.  Macrophages: Obligate Partners for Tumor Cell Migration, Invasion, and Metastasis , 2006, Cell.

[20]  N. H. Rod,et al.  Symptoms of sleep disordered breathing and risk of cancer: a prospective cohort study. , 2013, Sleep.

[21]  F. J. Nieto,et al.  Here come the sleep apnea-cancer studies. , 2013, Sleep.

[22]  C. Michiels,et al.  Intermittent hypoxia is a key regulator of cancer cell and endothelial cell interplay in tumours , 2008, The FEBS journal.

[23]  G. Semenza.  Hypoxia-inducible factors: mediators of cancer progression and targets for cancer therapy. , 2012, Trends in pharmacological sciences.

[24]  J. Pollard.  Tumour-educated macrophages promote tumour progression and metastasis , 2004, Nature Reviews Cancer.

[25]  W. McNicholas.  Obstructive sleep apnea and inflammation. , 2009, Progress in cardiovascular diseases.

[26]  C. Prior,et al.  Serum levels of vascular endothelial growth factor are elevated in patients with obstructive sleep apnea and severe night time hypoxia. , 2003, American journal of respiratory and critical care medicine.

[27]  D. Gozal,et al.  Effect of resveratrol on visceral white adipose tissue inflammation and insulin sensitivity in a mouse model of sleep apnea , 2014, International Journal of Obesity.

[28]  G. Semenza.  Oxygen sensing, homeostasis, and disease. , 2011, The New England journal of medicine.

[29]  Juen-Haur Hwang,et al.  Sleep apnea increased incidence of primary central nervous system cancers: a nationwide cohort study. , 2014, Sleep medicine.

[30]  F. Campos-Rodriguez,et al.  Mortality in obstructive sleep apnea-hypopnea patients treated with positive airway pressure. , 2005, Chest.

[31]  K. Basen-Engquist,et al.  Obesity and Cancer Risk: Recent Review and Evidence , 2011, Current oncology reports.

[32]  F. Barbé,et al.  Estrés oxidativo y síndrome de apneas-hipopneas del sueño , 2005 .

[33]  R. Farré,et al.  Sleep apnoea and cancer: current insights and future perspectives , 2012, European Respiratory Journal.

[34]  H. Nakano,et al.  Oxidative stress in obstructive sleep apnea. , 2005, Chest.

[35]  R. Farré,et al.  Association between sleep disordered breathing and aggressiveness markers of malignant cutaneous melanoma , 2014, European Respiratory Journal.

[36]  E. Rofstad,et al.  Tumors exposed to acute cyclic hypoxic stress show enhanced angiogenesis, perfusion and metastatic dissemination , 2010, International journal of cancer.

[37]  Dunqiang Ren,et al.  Effects of continuous positive airway pressure therapy on systemic inflammation in obstructive sleep apnea: a meta-analysis. , 2013, Sleep medicine.

[38]  N. Punjabi.  The epidemiology of adult obstructive sleep apnea. , 2008, Proceedings of the American Thoracic Society.

[39]  D. Gozal,et al.  Chronic sleep fragmentation induces endothelial dysfunction and structural vascular changes in mice. , 2014, Sleep.

[40]  Peter Vaupel,et al.  The role of hypoxia-induced factors in tumor progression. , 2004, The oncologist.

[41]  D. Navajas,et al.  Intermittent hypoxia enhances cancer progression in a mouse model of sleep apnoea , 2011, European Respiratory Journal.

[42]  P. Lloberes,et al.  Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment , 2002, European Respiratory Journal.

[43]  I. Melero,et al.  Molecular Pathways: Hypoxia Response in Immune Cells Fighting or Promoting Cancer , 2011, Clinical Cancer Research.

[44]  P. Span,et al.  Serum vascular endothelial growth factor: a prognostic factor in cervical cancer , 2009, Journal of Cancer Research and Clinical Oncology.

[45]  G. Tomlinson,et al.  Obstructive sleep apnea and the prevalence and incidence of cancer , 2014, Canadian Medical Association Journal.

[46]  Michael J Thun,et al.  Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. , 2003, The New England journal of medicine.

[47]  Markku Partinen,et al.  Sleep duration and breast cancer: a prospective cohort study. , 2005, Cancer research.

[48]  V. Grégoire,et al.  Preconditioning of the tumor vasculature and tumor cells by intermittent hypoxia: implications for anticancer therapies. , 2006, Cancer research.

[49]  B. Aggarwal,et al.  Inflammation and cancer: how friendly is the relationship for cancer patients? , 2009, Current opinion in pharmacology.

[50]  A. Yang,et al.  Sleep apnea and the subsequent risk of breast cancer in women: a nationwide population-based cohort study. , 2014, Sleep medicine.

[51]  P. Lavie,et al.  Plasma vascular endothelial growth factor in sleep apnea syndrome: effects of nasal continuous positive air pressure treatment. , 2002, American journal of respiratory and critical care medicine.

[52]  J. Pépin,et al.  Intermittent hypoxia and sleep-disordered breathing: current concepts and perspectives , 2008, European Respiratory Journal.

[53]  Daisuke Koya,et al.  Biology of Obesity: Lessons from Animal Models of Obesity , 2011, Journal of biomedicine & biotechnology.

[54]  F. Visseren,et al.  Obesity and Cancer: The Role of Dysfunctional Adipose Tissue , 2009, Cancer Epidemiology, Biomarkers & Prevention.

[55]  T. Young,et al.  Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. , 2008, Sleep.

[56]  Terry Young,et al.  Sleep-disordered breathing and cancer mortality: results from the Wisconsin Sleep Cohort Study. , 2012, American journal of respiratory and critical care medicine.