Radiotherapy and chemotherapy show no clear link to obstructive sleep apnea in head and neck cancer patients

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Head & neck Published June 2, 2026 Medically reviewed June 2, 2026 Study authors: Vannier Augustin G L, Kondamuri Neil S, Wu Megan S, Allen Janya, Rama Nihar, Nordgren Rachel, Agrawa… PubMed ↗ DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Interpret cautiously: current limited evidence does not support an increased risk of OSA with radiotherapy or chemotherapy in head and neck cancer.

This scoping review with exploratory meta-analysis examined the association between radiotherapy or chemotherapy and incident obstructive sleep apnea (OSA) in head and neck cancer patients. The analysis included 13 studies, though specific study designs and patient numbers were not detailed. The primary outcome was incident OSA, categorized by severity.

For mild OSA with radiotherapy, there was a modest, nonsignificant trend toward increased risk (z = 1.42, p = 0.15). For mild OSA with chemotherapy, no association was found (z = -0.83, p = 0.41). Similarly, moderate OSA with chemotherapy showed no association (z = 0.00, p = 1.00). The authors note that studies are limited in size and number, which restricts the reliability of these findings.

No safety data, adverse events, or follow-up duration were reported. The review does not support an increased risk of OSA with radiotherapy or chemotherapy based on current evidence. Clinicians should interpret these results cautiously due to the exploratory nature of the analysis and the small evidence base.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

PMID41552947

View Original Abstract ↓

BACKGROUND: Obstructive sleep apnea (OSA) may contribute to fatigue in head and neck cancer patients undergoing chemotherapy and radiotherapy, particularly as both have the potential to impact the mechanics and dynamics of the airway. We conducted a scoping review and exploratory meta-analysis to evaluate the risk of OSA following chemoradiation. METHODS: PubMed, Web of Science, EMBASE, and Cochrane Library were searched for studies assessing incident OSA after radiotherapy or chemotherapy. Eligible studies isolated the effect of one treatment and reported OSA rates in each group. RESULTS: Of 559 papers identified, 110 were duplicates and 30 underwent full-text review; 13 met criteria for exploratory meta-analysis. A modest, nonsignificant trend toward increased risk of mild OSA was observed with radiotherapy (z = 1.42, p = 0.15). Chemotherapy was not associated with mild (z = -0.83, p = 0.41) or moderate (z = 0.00, p = 1.00) OSA. CONCLUSIONS: Studies are limited in size and number, and do not support increased risk of OSA with radiotherapy.