دورية أكاديمية
أعرض في EDS

The effect of obstructive sleep apnea therapy on cardiovascular autonomic function: a systematic review and meta-analysis.

التفاصيل البيبلوغرافية
العنوان: The effect of obstructive sleep apnea therapy on cardiovascular autonomic function: a systematic review and meta-analysis.
المؤلفون: Dissanayake HU; Sleep Research Group, Charles Perkins Centre, University of Sydney, Australia.; Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Australia., Bin YS; Sleep Research Group, Charles Perkins Centre, University of Sydney, Australia.; Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Australia., Sutherland K; Sleep Research Group, Charles Perkins Centre, University of Sydney, Australia.; Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Australia.; Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, Australia., Ucak S; Sleep Research Group, Charles Perkins Centre, University of Sydney, Australia.; Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Australia., de Chazal P; Sleep Research Group, Charles Perkins Centre, University of Sydney, Australia.; School of Biomedical Engineering, University of Sydney, Sydney, NSW, 2006, Australia., Cistulli PA; Sleep Research Group, Charles Perkins Centre, University of Sydney, Australia.; Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Australia.; Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, Australia.
المصدر: Sleep [Sleep] 2022 Dec 12; Vol. 45 (12).
نوع المنشور: Meta-Analysis; Systematic Review; Journal Article
اللغة: English
بيانات الدورية: Publisher: Oxford University Press Country of Publication: United States NLM ID: 7809084 Publication Model: Print Cited Medium: Internet ISSN: 1550-9109 (Electronic) Linking ISSN: 01618105 NLM ISO Abbreviation: Sleep Subsets: MEDLINE
أسماء مطبوعة: Publication: 2017- : New York : Oxford University Press
Original Publication: New York, Raven Press.
مواضيع طبية MeSH: Continuous Positive Airway Pressure*/methods , Sleep Apnea, Obstructive*/complications , Sleep Apnea, Obstructive*/therapy, Humans ; Autonomic Nervous System/physiology ; Heart ; Heart Rate/physiology
مستخلص: Study Objectives: Autonomic function is impaired in obstructive sleep apnea (OSA) and may mediate the association between OSA and cardiovascular risk. We investigated the effect of OSA therapy on autonomic function through a systematic review and meta-analysis of intervention studies.
Methods: A systematic search using three databases (Medline, Embase, and Scopus) was performed up to December 9, 2020. Studies of OSA patients ≥ 18 years with autonomic function assessed before and after treatment with positive airway pressure, oral appliance, positional therapy, weight loss, or surgical intervention were included for review. Random effects meta-analysis was carried out for five groups of autonomic function indices. Risk of bias was assessed using the Cochrane Collaboration tool.
Results: Forty-three eligible studies were reviewed with 39 included in the meta-analysis. OSA treatment led to large decreases in muscle sympathetic nerve activity (Hedges' g = -1.08; 95% CI -1.50, -0.65, n = 8) and moderate decreases in catecholamines (-0.60; -0.94, -0.27, n = 3) and radio nucleotide imaging (-0.61; -0.99, -0.24, n = 2). OSA therapy had no significant effect on baroreflex function (Hedges' g = 0.15; 95% CI -0.09, 0.39, n = 6) or heart rate variability (0.02; -0.32, 0.36, n = 14). There was a significant risk of bias due to studies being primarily non-randomized trials.
Conclusions: OSA therapy selectively improves autonomic function measures. The strongest evidence for the effect of OSA therapy on autonomic function was seen in reduced sympathetic activity as assessed by microneurography, but without increased improvement in parasympathetic function. OSA therapy may reduce the risk of cardiovascular disease in OSA through reduced sympathetic activity.
(© Sleep Research Society 2022. Published by Oxford University Press on behalf of the Sleep Research Society.)
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فهرسة مساهمة: Keywords: autonomic nervous system; cardiovascular risk; catecholamines; heart rate variability; meta-analysis; obstructive sleep apnea; obstructive sleep apnea therapy; parasympathetic activity; sympathetic activity; systematic review
تواريخ الأحداث: Date Created: 20220915 Date Completed: 20221216 Latest Revision: 20221222
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC9742902
DOI: 10.1093/sleep/zsac210
PMID: 36107126
قاعدة البيانات: MEDLINE
الوصف
تدمد:1550-9109
DOI:10.1093/sleep/zsac210