Sleep disordered breathing and nocturnal hypoxemia are associated with an increased risk of lung cancer.

Obstructive sleep apnea (OSA) and nocturnal hypoxemia may predispose to lung cancer. Methods: We conducted a cross-sectional case control study including individuals participating in two prospective studies of home sleep apnea testing (HSAT) in the setting of newly diagnosed lung cancer (NCT02764866) and lung cancer screening (NCT02764866). HSAT, imaging studies, epidemiologic data, and a sleep questionnaire were available for all subjects. Patients with OSA defined as an AHI > 15 (Group A;n=129) were compared with controls with an AHI < 15 (Group B;n=173). Propensity score matching was used in order to evaluate the association between OSA, nocturnal hypoxemia, and lung cancer. Results: 302 patients were included by combining both cohorts. Salient patient characteristics are summarized in Table 1. Lung cancer was more prevalent in Group A than in Group B when measured by propensity score matching and nearest neighbor matching (p=0.015 and p=0.041 respectively). Binary logistic regression adjusted for confounders revealed an association between nocturnal hypoxemia and lung cancer, including the ODI3% (p=0.026) and the T90% (p=0.038). The association between AHI (p=0.075) and ODI4% (p=0.082) with lung cancer did not reach statistical significance, although a trend was seen. Conclusions: Sleep disordered breathing and nocturnal hypoxemia are associated with an increased risk of lung cancer.