Sleep apnea awakens cancer: A unifying immunological hypothesis

David Gozal, Isaac Almendros, Fahed Hakim

Research output: Contribution to journalComment/debate

24 Scopus citations


The presence of obstructive sleep apnea (OSA) in patients with cancer appears to be accompanied by poorer outcomes. However, the mechanisms underlying such association are unknown. We hypothesize that the constitutive characteristics of OS A, namely, intermittent hypoxia and sleep fragmentation, promote changes in the tumor microenvironment that ultimately lead to a disadvantageous immunosurveillance, thereby accelerating tumor proliferation and enhancing its invasiveness.

Original languageEnglish
Article numbere28326
Issue number3
StatePublished - 2014
Externally publishedYes

Bibliographical note

Funding Information:
D.G. is supported by National Institutes of Health grants HL-65270, HL-086662, and HL-107160. I.A. is supported by Beatriu de Pinós fellow ship from Generalitat de Catalunya (2010 BP_A 00238).


  • Angiogenesis
  • Intermittent hypoxia
  • Invasion
  • Macrophage polarity
  • Sleep apnea
  • Sleep fragmentation


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