Obstructive Sleep Apnea in Head and Neck Cancer Patients After Primary Treatment: A Review Focused on Oropharyngeal Cancer

Objective: Obstructive sleep apnea (OSA) is a disorder with significant health implications. Variations in upper airway anatomy and pharyngeal tone are factors that predispose patients to OSA. Oropharyngeal cancer (OPC) may increase the risk of OSA due to treatment-induced changes in the upper airway. This scoping review aims to assess the prevalence of OSA in OPC patients post-treatment. Data Sources: A search was conducted across multiple databases, including PubMed, Embase, and Cochrane Library, to identify studies reporting the prevalence of OSA in OPC patients post-treatment (including surgery, radiation, and/or chemoradiation). Review Methods: Studies were screened for eligibility by two reviewers. Inclusion criteria required studies to use standardized diagnostic criteria for OSA and provide prevalence data specifically for post-treatment OPC patients. Results: The search identified 788 studies: 30 underwent full-text review, and 13 studies with 373 head and neck cancer (HNC) patients met inclusion criteria. The majority of studies did not disaggregate data for OPC from other subsites; one study provided sufficient data on OSA prevalence in OPC patients post-treatment. Five studies reported AHI changes pre- and post-treatment with a mean change of 5.4 events/h with only 2 studies reporting significant changes in OSA rates. Sleep-related symptoms were captured in 11 studies with 2 comparing pre- and post-treatment. Conclusion: Despite the growing recognition of OSA as a potential comorbidity in cancer survivors, the literature does not adequately address the prevalence of OSA in OPC patients post-treatment. This highlights the need for future studies targeting OSA prevalence in this population using standardized diagnostic methods and reporting criteria.