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Association of Sleep Apnea and Cancer: From Animal Studies to Human Epidemiologic Data

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Impact of Sleep and Sleep Disturbances on Obesity and Cancer

Part of the book series: Energy Balance and Cancer ((EBAC,volume 8))

Abstract

This chapter describes results from both animal experiments and human studies that support the hypothesis that sleep apnea might increase the risk of cancer mortality. Following laboratory experiments that demonstrated the pro-oncogenic properties of hypoxia, a melanoma mouse model of sleep apnea showed that tumor growth is greatly enhanced by intermittent hypoxia that mimics the periodicity and intensity of that occurring in sleep apnea patients. This effect appears to be mediated by increased production of vascular endothelial growth factor (VEGF) and tumor vascularization and was stronger in lean than in obese mice. This chapter also describes the results of a 22-year follow-up study among participants in the Wisconsin Sleep Cohort Study showing that presence and severity of sleep apnea (as indicated by the apnea-hypopnea index) is associated with increased risk of total cancer mortality in a dose-response fashion. The association was even stronger when the hypoxemia index (percent sleep time below 90 % O2 saturation) was used to characterize sleep apnea severity.

This chapter also reviews evidence from recent epidemiologic studies that explore whether or not sleep apnea is also associated with increased cancer incidence. Finally, the strength of the evidence in support of the hypothesis of a causal link between sleep apnea and mortality is discussed, and recommendations for future research in this area are provided.

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Authors and Affiliations

  1. Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin—Madison, 610 Walnut Street, WARF Building 707C, Madison, WI, 53726, USA

    F. Javier Nieto M.D., M.P.H., Ph.D.

  2. Unitat de Biofísica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona-IDIBAPS-CIBERES, Barcelona, Spain

    Ramon Farré Ph.D.

Authors
  1. F. Javier Nieto M.D., M.P.H., Ph.D.
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  2. Ramon Farré Ph.D.
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Corresponding author

Correspondence to F. Javier Nieto M.D., M.P.H., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Medicine, Harvard Medical School Brigham and Women's Hospital, Boston, Massachusetts, USA

    Susan Redline

  2. Center for Science, Health & Society, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

    Nathan A. Berger

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Nieto, F.J., Farré, R. (2014). Association of Sleep Apnea and Cancer: From Animal Studies to Human Epidemiologic Data. In: Redline, S., Berger, N. (eds) Impact of Sleep and Sleep Disturbances on Obesity and Cancer. Energy Balance and Cancer, vol 8. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9527-7_6

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