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Obstructive Sleep Apnea in Head and Neck Cancer Survivors: A Systematic Review and Meta-Analysis
Om Chitnis1, J Joseph Caraway2, Ngun Cer Chin1
1Division of Otolaryngology Brook Army Medical Center San Antonio Texas USA.
OTO Open
|February 2, 2026
Summary
Head and neck cancer survivors have a high risk of obstructive sleep apnea (OSA) after treatment. Routine OSA screening is recommended for all survivors due to increased apnea-hypopnea index post-treatment.
Area of Science:
- Oncology
- Sleep Medicine
- Public Health
Background:
- Head and neck cancer (HNC) treatments can significantly impact patient health.
- Obstructive sleep apnea (OSA) is a common sleep disorder with serious health consequences.
Purpose of the Study:
- To systematically review and meta-analyze the risk of OSA in HNC survivors.
- To determine if HNC treatment increases OSA risk and if specific treatments are associated with higher OSA risk.
Main Methods:
- Comprehensive literature search across major databases (Embase, MEDLINE, Web of Science).
- Inclusion of studies using polysomnography in HNC patients pre- and post-treatment.
- Random effects meta-analyses to calculate OSA prevalence and apnea-hypopnea index (AHI) changes.
Main Results:
- 16 studies with 419 participants were included.
- Mean OSA prevalence in HNC survivors was 83.7%, increasing from 79.9% pre-treatment to 88.7% post-treatment.
- A statistically significant increase in AHI of 4.28 was observed after treatment.
Conclusions:
- High OSA prevalence exists in HNC survivors, irrespective of treatment modality.
- Routine screening for OSA in all HNC survivors is proposed.
- Early detection and management of OSA can improve outcomes for HNC survivors.
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