Untreated severe obstructive sleep apnea (OSA) is linked to increased aggressiveness of malignant cutaneous melanoma, according to research presented at the American Thoracic Society 2016 International Conference in San Francisco.

The study involved 412 patients, average age 55.8, with confirmed cases of cutaneous malignant melanoma. The number of men and women in the study group was approximately equal. Researchers looked at a number of factors that indicated patients’ prognosis, including the Clark and Breslow indices, which, taken together, determine the stage of melanoma.

All patients underwent a sleep study, and patients previously treated with CPAP (continuous positive airway pressure) were excluded. Patients diagnosed with the most aggressive cancers had higher prevalence and severity of obstructive sleep apnea, the study showed. This relationship was independent of age, gender, body mass index (BMI), skin type, sun exposure and other risk factors for melanoma.

"While more research is needed, this study shows that patients in the study had markers of poor prognosis for their melanoma. It also highlights the importance of diagnosing and treating sleep apnea,” says lead author Miguel Ángel Martinez-Garcia, MD, PhD, from the Hospital Universitario y Politécnico La Fe, Valencia, Spain, in a news release. “People who snore, frequently wake up at night or have daytime sleepiness should see a sleep specialist, especially if they have other risk factors for cancer or already have cancer. Physicians – especially dermatologists, cancer surgeons and medical oncologists – should ask their patients about potential sleep apnea symptoms, and refer them for a sleep study if they have these symptoms.”

The team is planning a multicenter/multinational study of patients with melanoma or other types of cancer, to examine the effect of long-term CPAP therapy on those also diagnosed with sleep apnea.