KEY POINTS
- This cross-sectional survey included 58 survivors who had completed curative-intent radiotherapy for head and neck cancer. Mean age was 56.6 years, 78.3% were men, and the oropharynx was the primary site in 58.6%.
- Half had received chemotherapy. Treatment was relatively homogeneous: 69% received 70 Gy, and 77.6% were treated in 33 fractions.
- On STOP-BANG screening, 21.4% were at high risk and 35.7% at intermediate risk for obstructive sleep apnoea. High-risk classification was more common than in an external community reference population, 21.4% versus 6.7%, corresponding to an odds ratio of 3.3 (95% CI 1.8–6.1).
- Some degree of snoring was reported by 62.5% of participants, 30.0% reported frequent snoring, and 32.1% reported loud snoring audible through a closed door or noticed by a bed partner.
- Poor sleep quality was identified in 69% of survivors. The mean Pittsburgh Sleep Quality Index was 3.1 points worse than population norms, with a large standardized effect size of 0.91.
- Elevated fatigue affected 51.7% of participants and was almost eight points worse than the external normative estimate, corresponding to a large effect size of 1.57.
- Insomnia was mild in 41.4%, moderate in 19.0%, and severe in 5.2%. However, mean insomnia severity was similar to population norms, and daytime sleepiness was only modestly elevated.
- No significant differences were identified by oropharyngeal versus other sites, estimated airway impact, or chemotherapy exposure. The study was small, cross-sectional, self-selected, unadjusted for major confounders, and used questionnaires rather than polysomnography or home sleep testing.
CLINICAL TAKEAWAY
Sleep disturbance and fatigue appear common enough to justify routine survivorship questioning after head and neck radiotherapy, even when daytime sleepiness is absent. STOP-BANG can flag risk, but it does not diagnose obstructive sleep apnoea; objective testing is required before treatment decisions.