Obstructive Sleep Apnea Burden at Diagnosis
OBSTRUCTIVE sleep apnea affected nearly half of never-smokers with newly diagnosed lung cancer in this prospective study.
Emerging evidence has suggested a possible association between obstructive sleep apnea and lung cancer, but smoking remains a major confounder in many datasets. In this prospective study, investigators focused specifically on never-smokers with newly diagnosed lung cancer to better define the prevalence and clinical features of obstructive sleep apnea in this population.
Among 77 enrolled patients, 67 were included in the final analysis. The median age was 65 years, 83.6% were women, and the median body mass index was 24 kg/m². Before any cancer treatment, patients underwent respiratory polygraphy. Obstructive sleep apnea, defined as a respiratory event index of at least five events per hour, was identified in 47.8% of patients. Moderate-to-severe disease, defined as a respiratory event index of at least 15 events per hour, was present in 20.9%.
Obstructive Sleep Apnea Across Cancer Stages
Most patients had adenocarcinoma, accounting for 97% of cases, and 67.2% had advanced-stage disease. The prevalence of obstructive sleep apnea was 29.4% in Stage I disease, 60.0% in Stage II, 65.0% in Stage III, and 44.0% in Stage IV. Although these figures suggest that obstructive sleep apnea was present across disease stages, the differences were not statistically significant.
The investigators also examined whether respiratory event index and nocturnal hypoxemia differed by stage. Neither respiratory event index nor the percentage of nighttime spent with oxygen saturation below 90% differed significantly between patients with early-stage and advanced-stage lung cancer. In multivariable logistic regression analyses, neither measure was associated with advanced-stage disease.
Why Proper Diagnosis Matters
These findings suggest that obstructive sleep apnea is common in never-smokers with lung cancer, including a meaningful proportion with moderate-to-severe disease. At the same time, the study did not show a significant association between obstructive sleep apnea severity, nocturnal hypoxemia, and advanced-stage presentation.
For clinicians, the key message is not that obstructive sleep apnea predicts more advanced lung cancer in this cohort, but that it may be underrecognized in a population already carrying substantial disease burden. The authors concluded that proper diagnosis and management deserve attention, particularly in never-smokers with newly diagnosed lung cancer.
Reference:
Park J et al. Obstructive sleep apnea in never-smokers with newly diagnosed lung cancer: a prospective study in a predominantly female Korean population. Sci Rep. 2026;DOI:10.1038/s41598-026-45232-7.
Featured Image: Rafael Ben-Ari on Adobe Stock.
