دورية أكاديمية
أعرض في EDS

Long-term effects on clinical event, mental health, and related outcomes of CPAP for obstructive sleep apnea: a systematic review.

التفاصيل البيبلوغرافية
العنوان: Long-term effects on clinical event, mental health, and related outcomes of CPAP for obstructive sleep apnea: a systematic review.
المؤلفون: Balk EM; Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island., Adam GP; Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island., Cao W; Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island., Bhuma MR; Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island., D'Ambrosio C; Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut., Trikalinos TA; Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island.
المصدر: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2024 Jun 01; Vol. 20 (6), pp. 895-909.
نوع المنشور: Systematic Review; Journal Article
اللغة: English
بيانات الدورية: Publisher: American Academy of Sleep Medicine Country of Publication: United States NLM ID: 101231977 Publication Model: Print Cited Medium: Internet ISSN: 1550-9397 (Electronic) Linking ISSN: 15509389 NLM ISO Abbreviation: J Clin Sleep Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Darien, IL : American Academy of Sleep Medicine, 2005-
مواضيع طبية MeSH: Sleep Apnea, Obstructive*/therapy , Sleep Apnea, Obstructive*/complications , Continuous Positive Airway Pressure*/methods , Continuous Positive Airway Pressure*/statistics & numerical data, Humans ; Mental Health/statistics & numerical data ; Treatment Outcome
مستخلص: Study Objectives: We performed a systematic review of long-term health outcomes of continuous positive airway pressure (CPAP) use in adults with obstructive sleep apnea.
Methods: We updated prior systematic reviews with searches in multiple databases through January 3, 2023. We included randomized controlled trials (RCTs) and adjusted nonrandomized comparative studies that reported prespecified long-term (mostly > 1 year) health outcomes. We assessed risk of bias, conducted meta-analyses, and evaluated strength of evidence.
Results: We found 38 eligible studies (16 trials, 22 observational). All conclusions were of low strength of evidence given study and data limitations. RCTs found no evidence of effect of CPAP on mortality (summary effect size [ES] 0.89; 95% confidence interval [CI] 0.66, 1.21); inclusion of adjusted nonrandomized comparative studies yields an association with reduced risk of death (ES 0.57; 95% CI 0.44, 0.73). RCTs found no evidence of effects of CPAP for cardiovascular death (ES 0.99; 95% CI 0.64, 1.53), stroke (ES 0.99; 95% CI 0.73, 1.35), myocardial infarction (ES 1.05; 95% CI 0.78, 1.41), incident atrial fibrillation (ES 0.89; 95% CI 0.48, 1.63), or composite cardiovascular outcomes (all statistically nonsignificant). RCTs found no evidence of effects for incident diabetes (ES 1.02; 95% CI 0.69, 1.51) or accidents (all nonsignificant) and no clinically significant effects on depressive symptoms, anxiety symptoms, or cognitive function.
Conclusions: Whether CPAP use for obstructive sleep apnea affects long-term health outcomes remains largely unanswered. RCTs and nonrandomized comparative studies are inconsistent regarding the effect of CPAP on mortality. Current studies are underpowered, with relatively short duration follow-up and methodological limitations.
Citation: Balk EM, Adam GP, Cao W, Bhuma MR, D'Ambrosio C, Trikalinos TA. Long-term effects on clinical event, mental health, and related outcomes of CPAP for obstructive sleep apnea: a systematic review. J Clin Sleep Med . 2024;20(6):895-909.
(© 2024 American Academy of Sleep Medicine.)
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فهرسة مساهمة: Keywords: cardiovascular disease; clinical outcomes; continuous positive airway pressure device; meta-analysis; obstructive sleep apnea; systematic review
تواريخ الأحداث: Date Created: 20240201 Date Completed: 20240603 Latest Revision: 20240605
رمز التحديث: 20240605
مُعرف محوري في PubMed: PMC11145052
DOI: 10.5664/jcsm.11030
PMID: 38300818
قاعدة البيانات: MEDLINE
الوصف
تدمد:1550-9397
DOI:10.5664/jcsm.11030