Sleep-Disordered Breathing and Nocturnal Hypoxia in Cancer Patients: A Stomatological and Airway Assessment Framework.

BACKGROUND: Patients with cancer frequently experience sleep-related symptoms and physiological disturbances that may be associated with sleep-disordered breathing (SDB) and nocturnal hypoxia. Although these conditions have attracted increasing attention in oncology, the potential contribution of craniofacial restriction and upper airway dysfunction remains insufficiently recognized in routine clinical practice. OBJECTIVE: To propose a stomatological and upper airway assessment framework for the identification of anatomical factors that may contribute to sleep-disordered breathing and nocturnal hypoxia in adults with cancer. METHODS: This narrative review integrates current evidence on sleep-disordered breathing, nocturnal hypoxia, craniofacial development, and upper airway dysfunction. The proposed framework was developed from recurrent clinical observations in adults with cancer together with a narrative synthesis of the available literature, with emphasis on anatomical findings identifiable during routine stomatological examination. MAIN FINDINGS: Current evidence indicates that anatomical features such as maxillary constriction, nasal airway narrowing, altered craniofacial development, and ankyloglossia may contribute to upper airway dysfunction and nocturnal hypoxia. Despite increasing recognition of the systemic consequences of nocturnal hypoxia, these upstream anatomical factors are rarely incorporated into routine oncological assessment. Based on the available evidence, a practical clinical framework is proposed to facilitate early identification of patients who may benefit from further respiratory evaluation. CONCLUSION: Integrating stomatological and upper airway assessment into the multidisciplinary evaluation of adults with cancer may improve recognition of previously unrecognized sleep-disordered breathing and nocturnal hypoxia. This framework provides a clinically applicable approach for identifying potentially modifiable anatomical contributors to respiratory dysfunction and may support future research evaluating their relevance in supportive cancer care.