OSA and Cancer Link

[Chevie]

So no, according to this study, CPAP doesn't cause cancer either!!

Thank you. I will go back to using my CPAP tonight. Hanging by my ankles from the rafters was fairly effective, but a tad uncomfortable.

[Pneumophile]

lol

Seriously now, I'm thinking of sleeping face down on a special foam pillow, still on the blower and chinstrap of course. Anything to get that AHI below 1.0 consistently. Sleeping on my back definitely blocks the airway; I gave that up decades ago, long before my OSA diagnosis. So maybe sleeping face down rather than on my side will be an improvement.

Any thoughts anyone?

[ChicagoGranny]

I'm thinking of sleeping face down on a special foam pillow, still on the blower and chinstrap of course. Anything to get that AHI below 1.0 consistently.

Make sure to consider whether this is an achievable long-term strategy. The face-down part would concern me.

If you want to try sleeping on your stomach while using CPAP, here is the proper way to do it - http://www.uarsrelief.com/sleeppositions.html

I'm thinking of sleeping face down on a special foam pillow, still on the blower and chinstrap of course. Anything to get that AHI below 1.0 consistently.

Personally, this would not work for me. First, I would try sleeping on back or sides while using a firm foam cervical collar sans chinstrap. (I have slept this way for several years.)

A chinstrap tends to pull the lower jaw backwards - bad for apnea. It also interferes with the mask headgear. A cervical collar will not pull the lower jaw backwards and will not interfere with the headgear. An additional benefit of the collar is that it holds the neck in the best position for airway patency.

If you decide to try a collar, I can recommend exact model and source.

[Julie]

Will your 'special' foam pillow keep your CO2 vent UNcovered when you sleep?

[OhHelpMe]

CO2 vent

It's an air vent, not a CO2 vent.

Expired air is about 78% nitrogen, 15% oxygen, 4.5% carbon dioxide and traces of argon and other gases.

[Pneumophile]

Will your 'special' foam pillow keep your CO2 vent UNcovered when you sleep?

I'll only know that if and when I get one but good question. My Swift FX mask is a minimalist design at least.

[Pneumophile]

I'm thinking of sleeping face down on a special foam pillow, still on the blower and chinstrap of course. Anything to get that AHI below 1.0 consistently.

Make sure to consider whether this is an achievable long-term strategy. The face-down part would concern me.

If you want to try sleeping on your stomach while using CPAP, here is the proper way to do it - http://www.uarsrelief.com/sleeppositions.html

I'm thinking of sleeping face down on a special foam pillow, still on the blower and chinstrap of course. Anything to get that AHI below 1.0 consistently.

Personally, this would not work for me. First, I would try sleeping on back or sides while using a firm foam cervical collar sans chinstrap. (I have slept this way for several years.)

A chinstrap tends to pull the lower jaw backwards - bad for apnea. It also interferes with the mask headgear. A cervical collar will not pull the lower jaw backwards and will not interfere with the headgear. An additional benefit of the collar is that it holds the neck in the best position for airway patency.

If you decide to try a collar, I can recommend exact model and source.

Excellent comments. It concerns me too but I might give it a try. The cost of failure is minimal.

I'll give the "partial swast .." err, I mean the "Falcon" position a try but my soft tissues will still be positioned sideways. Still, body alignment looks good. Lately I've tried keeping my head "looking up" as I sleep because "looking down" surely blocks the airway.

Yes, a chinstrap will pull the jaw backwards - an unfortunate side-effect of keeping the mouth closed. Please PM me with the surgical collar info, I'm very open to suggestions.

Apologies for diverting this thread. My bad. I might read those two papers that did show an association between OSA and cancer. The 2014 Canadian paper did discuss them both and attempted to explain the discrepancy in findings as any good publication should but it's always best to go to the source.

[Pneumophile]

Here is a link to an Australian study of untreated OSA.

Sleep Apnea and 20-Year Follow-Up for All-Cause Mortality, Stroke, and Cancer Incidence and Mortality in the Busselton Health Study Cohort

Note the part in the study that the patients were untreated.

The emerging but strong association with cancer is a key
area for further investigation aimed at determining causality.

I finally got around to reading this Australian study. A few thoughts .....

- The statistical methods look sound. Univariate and multivariate Cox Proportionate Hazard analysis, Kaplan-Meier curves, Fisher's exact test, Kruskal-Wallis etc etc.
- It's unfortunate that the male/female ratio was about 70/30 in this study. According to the authors this was "... because in 1990 sleep apnea was thought to be a relatively rare condition in women before the publication of the Wisconsin cohort in 1993." In my view it was even then NOT good to make such an assumption when based on inadequate prior data - hopefully such a mistake will not be made again. Consideration of male vs female gender as a potential confounder of the results is compromised by this imbalance, which could easily have been avoided.
- The authors believe that likely none of the residents of Busselton (a town in Western Australia) involved in this study decided to get treated by CPAP or by other means after OSA diagnosis - see paper for details. Well, at least this minimizes the possibility of the conclusions being confounded by such treatment. To quote the authors, "Effective sleep apnea treatment could reduce risk and treatment of the population would bias towards a null [no statistical significance] finding." Indeed it would.
- Hazard Ratios (fully adjusted) for moderate/severe OSA vs No OSA or Mild OSA were 4.2 for all-deaths, 3.4 for cancer deaths, 2.5 for cancer incidence and 3.7 for stroke - all statistically significant. These findings would be of great clinical interest if the study had been properly designed and powered. Note: a Hazard Ratio of 4 for all-deaths means that risk of death in the moderate/severe OSA group was FOUR TIMES the risk of death in the No OSA/Mild OSA group. That is a whopping difference!
- There were only 18 subjects in all of the "Moderate-to-Severe" OSA subset analyses, with 294 subjects in the "No OSA" subset and 81 subjects in the "Mild" OSA group (see e.g. Table 1, Figures 1 through 6). So when the data were analyzed, 375 subjects were in the low risk group (No or mild OSA) and precisely 18 subjects were in the high risk (moderate-to-severe OSA) group. This is a very big problem in this paper, as is admitted by the authors in the Discussion section. No wonder the 95% confidence limits (a measure of the limit of statistical significance between groups) are so high in all of the Moderate-to-Severe subset results - just look at the shaded areas for Moderate-to-Severe OSA in all of the graphs. Frankly such an imbalanced subset analysis would not be published in many of the oncology journals I'm familiar with. At least the authors are candid about this issue: "Underpowering is probably the biggest limitation to the Busselton Sleep Cohort, particularly with only 18 people in the highest exposure category." You can say that again.
- This study needs some sensitivity analyses to address the major underpowering issue - what would the effect on analysis results if one, or two, or three of the high-risk category subjects were moved to the low-risk category (either at random or by OSA severity ranking as defined here)? My view is that the outcome would be very sensitive to such changes.
- The authors end the paper as follows: "Finally, the external validity of these findings might be questionable because all of the data arise from [a small number of] people living in one town in Western Australia [with likely confounding factors that were not known to the investigators]." (my text in square brackets of course) You can say that again.

But I do think that this paper should have been published. The study does have these limitations but the analysis methods were appropriate and the authors did the best that they could with the available raw data. It is perfectly normal in science for publications to lead to differing conclusions for reasons that hopefully will get sorted out in the end but right now imho there are no solid data linking OSA to cancer.

[LSAT]

CO2 vent

It's an air vent, not a CO2 vent.

Expired air is about 78% nitrogen, 15% oxygen, 4.5% carbon dioxide and traces of argon and other gases.

If you are going to be technical about this, cpap.com describes it as an "exhalation port".

[DreamStalker]

My mother, who is most certainly NOT a doctor, called me yesterday, on my first day back from vacation, to tell me I should stop using my CPAP because she thinks it could give me cancer. What?! Her reasoning is that my uncle (not blood-related) has aggressive brain cancer that is not responding to treatment and he used a CPAP for 5 years for OSA. She told me to "read about it."

Well, the only thing I came up with is that there's a link between having OSA and getting cancer. But no link found regarding CPAP usage. Anyone have more thoughts or research on this? I'm not saying I believe her, but I'm also disturbed to find out about the link between OSA and cancer. Here's one article to look over:

http://well.blogs.nytimes.com/2012/05/2 ... risk/?_r=0

First of all, you and 99% of most others need to understand that correlation statistics cannot be interpreted as causative diagnosis. Cancer and sleep apnea may well be correlated but that does not mean that either causes the other. For example, the chart below shows a 97% correlation between amount of lemons imported from Mexico and the US highway fatality rate (fatalities per 100,000 of US population) ...

... but that does not mean that Mexican lemon imports cause US highway deaths or that US highway deaths cause an increase in Mexican lemon imports.

Second, new research has discovered older research by Otto Warburg (1920's) that cancer is actually caused by a metabolic disease and not by genetics .... or sleep apnea treatment. Google Thomas N. Seyfried and/or read his book, watch his youTube lectures, and educate yourself, your mother, and more importantly your uncle.

Third, as is cancer, cardiovascular, diabetes, and most neurological diseases are all caused by metabolic/mitochondrial dysregulation -- and ALL are reversible.

[purple22]

Brain cancer can be genetic, perhaps not more likely than blaming it on OSA, or xPAP. Best to keep an open mind to the possibility, remembering early detection is worth a whole trainload of cure. If you see a reason to do some kind of cancer screening, then do not hesitate.

Do find out what kind of cancer your relative died from. Ask a doctor if this particular cancer might be genetic.

Ask your dog what he thinks. Dogs can recognize that something is wrong with you before the doctor. Dogs can communicate, and they likely care more about you than your doctor.

[Goofproof]

Brain cancer can be genetic, perhaps not more likely than blaming it on OSA, or xPAP. Best to keep an open mind to the possibility, remembering early detection is worth a whole trainload of cure. If you see a reason to do some kind of cancer screening, then do not hesitate.

Do find out what kind of cancer your relative died from. Ask a doctor if this particular cancer might be genetic.

Ask your dog what he thinks. Dogs can recognize that something is wrong with you before the doctor. Dogs can communicate, and they likely care more about you than your doctor.

Dog's can treat what's wrong with you, the prescription the write, is love. Jim

[Pneumophile]

DreamStalker,
Please explain to us in some detail your understanding of the concepts "oncogene" and "tumor suppressor gene". The same goes for the concepts "germline mutation" and "somatic mutation" in the context of cancer.
Thanks in advance, Pneumo.
p.s. metabolic alterations are certainly important in cancer but your post is arrant nonsense, oncologically speaking. Or utter balderdash, if you prefer.

[palerider]

DreamStalker,
... your post is arrant nonsense, oncologically speaking. Or utter balderdash, if you prefer.

most of his are, when examined closely. I haven't picked apart his nutrition posts, but the garbage in other posts makes me suspect them.

[Eddie Fasolino]

your post is arrant nonsense, oncologically speaking. Or utter balderdash, if you prefer.

All of his posts follow that pattern. I suspect pretty severe mental illness.

Maybe he went too many years before seeking CPAP treatment?

This tells you something else:

DreamStalker wrote:
I've spent the last several years downloading as much health, farming, and self-sufficent information as I can find and storing it on my own database.

He has met the apocalypse, and it is he.