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Vol. 51. Issue 9.
Pages 456-461 (September 2015)
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Vol. 51. Issue 9.
Pages 456-461 (September 2015)
Review
Relationship Between Sleep Apnea and Cancer
Relación entre apnea del sueño y cáncer
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Miguel Ángel Martínez-Garcíaa,d,
Corresponding author
mianmartinezgarcia@gmail.com

Corresponding author.
, Francisco Campos-Rodríguezb, Isaac Almendrosc,d, Ramón Farréc,d
a Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
b Servicio de Neumología, Hospital Valme, Sevilla, Spain
c Unidad de Biofísica y Bioingeniería, Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain
d CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Table 1. Studies Analyzing the Association Between SAHS and Cancer in Humans.
Table 2. Future Research Goals for Associating of SAHS With Cancer.
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Abstract

In the light of relationships reported between hypoxemia (tissue hypoxia) and cancer, Abrams et al. concluded in 2008 that sleep apnea-hypopnea syndrome (SAHS) and its main consequence, intermittent hypoxia, could be related with increased susceptibility to cancer or poorer prognosis of a pre-existing tumor. This pathophysiological association was confirmed in animal studies. Two large independent historical cohort studies subsequently found that the degree of nocturnal hypoxia in patients with SAHS was associated with higher cancer incidence and mortality. This finding has been confirmed in almost all subsequent studies, although the retrospective nature of some requires that they be considered as hypothesis-generating only. The relationship between sleep apnea and cancer, and the pathophysiological mechanisms governing it, could be clarified in the near future in a currently on-going study in a large group of melanoma patients.

Keywords:
Sleep apnea
SAHS
Cancer
Intermittent hypoxia
Intermittent hypoxemia
Resumen

En 2008, Abrams et al. publicaron que, habida cuenta de las anteriores relaciones encontradas entre la hipoxemia (hipoxia tisular) y el cáncer, el síndrome de apneas e hipopneas del sueño (SAHS) y su principal consecuencia, la hipoxia intermitente, podrían relacionarse con una mayor propensión a padecer cáncer o a un peor pronóstico de un tumor preexistente. Con esta base fisiopatológica y tras algunos estudios en animales que confirmaron esta asociación, 2 grupos independientes de investigación observaron en sendos estudios clínicos amplios de cohortes históricas que el grado de hipoxia nocturna aparecida en pacientes con SAHS se asociaba a una mayor incidencia y mortalidad por cáncer. Este dato ha sido confirmado por casi todos los estudios posteriores, si bien el carácter retrospectivo de todos ellos obliga a considerarlos tan solo como trabajos generadores de hipótesis. Un estudio puesto en marcha actualmente sobre un amplio grupo de pacientes con melanoma posiblemente arroje más luz en un futuro cercano sobre la existencia o no de esta relación y de los mecanismos fisiopatológicos que la gobiernan.

Palabras clave:
Apnea del sueño
SAHS
Cáncer
Hipoxia intermitente
Hipoxemia intermitente

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