Department of Otorhinolaryngology, Head & Neck Surgery, United Christian Hospital, Hong Kong; School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
Sleep Med Rev. 2014 Feb;18(1):19-24. doi: 10.1016/j.smrv.2013.05.003. Epub 2013 Jul 3.
Obstructive sleep apnea (OSA), caused by the obstruction of the upper airway, is the most common type of sleep apnea. Continuous positive airway pressure (CPAP) and positional therapy have been shown to be effective to improve positional OSA.
To compare the effectiveness of positional therapy versus CPAP on positional OSA.
Prospective randomized trials were systematically searched from the OVID databases. The trials comparing positional therapy versus CPAP in patients with positional OSA were included. Apnea-hypopnea index (AHI), mean oxygen saturation level, arousal index, sleep efficiency, and sleep time were the outcomes of this meta-analysis.
Three crossover trials were identified from Canada, New Zealand, and United States from 1999 to 2010. A total of 71 patients were randomly assigned to receive CPAP or positional therapy and the mean age of patients was 51 y. Positional therapy showed higher AHI (mean difference, MD: 4.28, 95% CI: 0.72-7.83) and lower oxygen saturation level (MD: -1.04, 95% CI: -1.63 to -0.46) than CPAP. It showed no distinct advantage over CPAP in terms of arousal index, sleep efficiency, and total sleep time, but CPAP reduced sleep time in the supine position.
CPAP is superior to positional therapy in reducing the severity of sleep apnea and increasing the oxygen saturation level in patients with positional OSA.
阻塞性睡眠呼吸暂停（OSA）是由上气道阻塞引起的，是最常见的睡眠呼吸暂停类型。持续气道正压通气（CPAP）和体位治疗已被证明能有效改善体位性 OSA。
比较体位治疗与 CPAP 治疗体位性 OSA 的效果。
系统地从 OVID 数据库中搜索前瞻性随机试验。纳入比较体位治疗与 CPAP 治疗体位性 OSA 患者的试验。本荟萃分析的结局为呼吸暂停-低通气指数（AHI）、平均氧饱和度水平、觉醒指数、睡眠效率和睡眠时间。
从 1999 年至 2010 年，在加拿大、新西兰和美国共发现了 3 项交叉试验。共有 71 例患者被随机分配接受 CPAP 或体位治疗，患者的平均年龄为 51 岁。与 CPAP 相比，体位治疗的 AHI 更高（平均差异，MD：4.28，95%CI：0.72-7.83），氧饱和度水平更低（MD：-1.04，95%CI：-1.63 至-0.46）。与 CPAP 相比，体位治疗在觉醒指数、睡眠效率和总睡眠时间方面并没有明显优势，但 CPAP 减少了仰卧位睡眠时间。
CPAP 治疗体位性 OSA 可降低睡眠呼吸暂停严重程度，提高氧饱和度水平，优于体位治疗。
