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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

Transient radiation-induced severe obstructive sleep apnea.

Vinicius M Palma¹, Pedro O T Silva¹, Gilberto G S Formigoni¹

¹Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine

|September 27, 2024

Summary

Head and neck radiotherapy can cause severe obstructive sleep apnea (OSA). This case study shows that OSA symptoms following radiation treatment may unexpectedly resolve, indicating it might not be a permanent condition.

Keywords:

head and neck cancer obstructive sleep apnea radiotherapy transient

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Area of Science:

Oncology
Sleep Medicine
Otolaryngology

Background:

Radiotherapy for head and neck cancer is a known risk factor for developing or exacerbating obstructive sleep apnea (OSA).
Potential causes include treatment-related neurological impairment, muscle atrophy, edema, and xerostomia.

Observation:

A patient developed severe OSA three months post-radiochemotherapy and neck dissection for squamous cell carcinoma.
Polysomnography confirmed severe OSA, which persisted for six months despite non-adherence to treatment.
Unexpectedly, the patient's OSA symptoms completely resolved over time.

Findings:

A follow-up polysomnography one year after radiotherapy showed no evidence of OSA.
This case demonstrates that radiation-induced severe obstructive sleep apnea may be transient.
Complete resolution of OSA occurred without specific OSA treatment adherence.

Implications:

Recent OSA diagnosis post-head and neck radiotherapy should not automatically assume a lifelong prognosis.
Further research is warranted to understand the mechanisms of transient OSA following radiation therapy.
Clinical management should consider the potential for spontaneous resolution of sleep-disordered breathing.