Taveira Karinna Veríssimo Meira, Kuntze Morgane Marion, Berretta Fernanda, de Souza Beatriz Dulcineia Mendes, Godolfim Luiz Roberto, Demathe Thiago, De Luca Canto Graziela, Porporatti André Luís
Department of Morphology, Center of Biosciences, Federal University of Rio Grande do Norte, Natal, Brazil.
Federal University of Santa Catarina, Florianópolis, Brazil.
J Oral Rehabil. 2018 Nov;45(11):890-902. doi: 10.1111/joor.12686. Epub 2018 Jul 18.
The aim of this systematic review was to answer the focused question, "Is there an association between obstructive sleep apnea (OSA) and alcohol, caffeine or tobacco use?" Five electronic databases (Cinahl, Literatura Latth American and Caribbean, PubMed, Scopus, Web of Science) and 3 grey literature (Google Acadêmico, ProQuest, OpenGrey) were searched, as well as search on reference list of included papers and contacts with study authors. Observational studies were included. The Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) tool assessed the potential risk of bias (RoB) among the studies, while the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach determined the level of evidence. Meta-Analysis was performed with RevMan 5.3 software. Among 3,442 identified studies, 14 were included. Eleven studies were classified as moderate RoB and 3 as high RoB. Meta-analysis showed OSA has no association with tobacco and presented a positive association with alcohol. The odds ratio for OSA increased almost 1.33 times (95% confidence interval [CI]; 1.10-1.62) for alcohol users. There was insufficient published data to evaluate whether OSA is associated with caffeine. The overall quality of evidence ranged from low to very low. OSA was associated with the use of alcohol, however there is not enough evidence to confirm the association with tobacco or caffeine. Due to the very low GRADE level of evidence, caution should be applied when considering these findings.
“阻塞性睡眠呼吸暂停（OSA）与酒精、咖啡因或烟草使用之间是否存在关联？”检索了五个电子数据库（护理学与健康领域数据库、拉丁美洲和加勒比地区文献数据库、医学期刊数据库、Scopus数据库、科学引文索引数据库）和三个灰色文献数据库（谷歌学术、ProQuest数据库、OpenGrey数据库），并对纳入论文的参考文献列表进行了检索，还与研究作者进行了联系。纳入了观察性研究。统计评估与综述工具的Meta分析（MAStARI）工具评估了研究中潜在的偏倚风险（RoB），而推荐分级的评估、制定与评价（GRADE）方法确定了证据水平。使用RevMan 5.3软件进行Meta分析。在3442项已识别的研究中，纳入了14项。11项研究被归类为中度RoB风险研究，3项为高度RoB风险研究。Meta分析表明，OSA与烟草无关联，与酒精呈正相关。酒精使用者患OSA的比值比增加了近1.33倍（95%置信区间[CI]；1.10 - 1.62）。没有足够的已发表数据来评估OSA是否与咖啡因有关联。证据的总体质量从低到非常低。OSA与酒精使用有关联，然而，没有足够的证据证实与烟草或咖啡因的关联。由于证据的GRADE水平非常低，在考虑这些发现时应谨慎。
