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Obstructive sleep apnea promotes cancer development and progression: a concise review

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Abstract

Background

Obstructive sleep apnoea-hypopnoea (OSA) is an increasingly common sleep disorder which is widely accepted to be associated with high rates of morbidity and mortality. OSA is an independent risk factor for cardiovascular diseases, cerebrovascular disease, and metabolic disease. Recently, several studies have demonstrated that patients with OSA have a higher prevalence of cancer and cancer-related mortality. The epidemiological surveys suggest that patients with OSA had a higher incidence of cancer and cancer-related mortality than patients without OSA. Animal studies indicate that the activation of HIF-1 and VEGF pathways in response to intermittent hypoxia may promote the blood supply which supports tumor growth. In addition, tumor-associated macrophages may be altered by intermittent hypoxia (or sleep fragmentation) to a tumor-promoting phenotype yielding more aggressive cancer behavior.

Conclusions

The relationship between OSA and cancer has been confirmed, in which patients with OSA have a relative high prevalence of cancer and cancer-related mortality. The mechanism of OSA promoting cancer development and progression may be related with intermittent hypoxia and possibly sleep fragmentation. The activation of several cancer-related pathways may play an important role in tumor growth and metastasis. More clinical data and basic studies are needed to explain and confirm the relationship between OSA and cancer.

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Acknowledgments

The authors wish to thank Professor David P White (Brigham and Women’s Hospital-Harvard Medical School, USA) for giving some good ideas and suggestions for the paper and in revising the text. This work was supported by the National Natural Science Foundation of China [Grant no. 81270144, 81170071].

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Sleep Breathing Disorder Research Group, Department of Respiratory Medicine, Tianjin General Hospital, Tianjin Medical University, Anshan Road, Tianjin, 300052, China

    Jie Cao, Jing Feng, Lian Li & Baoyuan Chen

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  1. Jie Cao
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  2. Jing Feng
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Correspondence to Baoyuan Chen.

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Cao, J., Feng, J., Li, L. et al. Obstructive sleep apnea promotes cancer development and progression: a concise review. Sleep Breath 19, 453–457 (2015). https://doi.org/10.1007/s11325-015-1126-x

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