• Miguel Angel Martinez-Garcia, Francisco Campos-Rodriguez, Eduardo Nagore, Antonio Martorell, Jose Luis Rodriguez-Peralto, Erica Riveiro-Falkenbach, Luis Hernandez, Jose Bañuls, Eva Arias, Pablo Ortiz, Valentin Cabriada, Jose Gardeazabal, Josep Maria Montserrat, Cristina Carrera, Jaime Corral, Juan Fernando Masa, de TerrerosJavier GomezJGRespiratory Department, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain., Jorge Abad, Adam Boada, Olga Mediano, Esther de Eusebio, Eusebi Chiner, Pedro Landete, Mercedes Mayos, Ana Fortuño, Ferrán Barbé, Manuel Sánchez de la Torre, Alicia Sanchez de la Torre, Irene Cano, Cristina Gonzalez, Amalia Pérez-Gil, Teresa Gómez-García, Daniela Cullen, Maria Somoza, Manuel Formigón, Felipe Aizpuru, Cristina Navarro, Maria Jose Selma-Ferrer, Alberto Garcia-Ortega, Blanca de Unamuno, Isaac Almendros, Ramón Farré, David Gozal, and Spanish Sleep Network.
• Respiratory Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain. Electronic address: mianmartinezgarcia@gmail.com.
• Chest. 2018 Dec 1; 154 (6): 134813581348-1358.

BackgroundSleep-disordered breathing (SDB) has been associated with a greater incidence and mortality of cancer, although such findings are inconsistent. However, no large studies are currently available to investigate this association in patients with a specific type of cancer. This study seeks to assess potential relationships between SDB severity and aggressiveness markers of cutaneous melanoma.MethodsFour hundred and forty-three patients with a diagnosis of melanoma underwent a sleep study within 6 months of diagnosis. General demographics were collected, along with melanoma characteristics and polygraphic parameters consisting of the apnea-hypopnea index (AHI) and indices of both continuous and intermittent night-time oxyhemoglobin desaturation (DI4%). An exploration of independent relationships between SDB and various objective melanoma aggressiveness markers (Breslow index, presence of ulceration, presence of regression, mitotic index, stage of severity, damage to the sentinel lymph, and spreading of the melanoma) was performed.ResultsPatients in the upper tertiles of AHI or DI4% were 1.94 (95% CI, 1.14-3.32; P = .022) and 1.93 (95% CI, 1.14-3.26; P = .013) times more likely, respectively, to present with aggressive melanoma (Breslow index > 1 mm) than those in the lowest tertiles of these sleep attributes after adjustment for age, sex, tumor location, and BMI. This association was particularly prominent among patients < 56 years of age with Breslow index > 2 mm. The presence of the additional markers of aggressiveness was also associated with higher AHI and DI4% values.ConclusionsThe severity of SDB was independently associated with greater aggressiveness of cutaneous melanoma, particularly among younger patients.Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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