Obstructive Sleep Apnea Following Head and Neck Chemoradiation: A Scoping Review With Exploratory Meta-Analysis.

Abstract

Obstructive sleep apnea (OSA) may contribute to fatigue in head and neck cancer patients undergoing chemotherapy and radiotherapy, particularly as both have the potential to impact the mechanics and dynamics of the airway. We conducted a scoping review and exploratory meta-analysis to evaluate the risk of OSA following chemoradiation. PubMed, Web of Science, EMBASE, and Cochrane Library were searched for studies assessing incident OSA after radiotherapy or chemotherapy. Eligible studies isolated the effect of one treatment and reported OSA rates in each group. Of 559 papers identified, 110 were duplicates and 30 underwent full-text review; 13 met criteria for exploratory meta-analysis. A modest, nonsignificant trend toward increased risk of mild OSA was observed with radiotherapy (z = 1.42, p = 0.15). Chemotherapy was not associated with mild (z = -0.83, p = 0.41) or moderate (z = 0.00, p = 1.00) OSA. Studies are limited in size and number, and do not support increased risk of OSA with radiotherapy.