Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA.
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Sleep Med. 2023 Aug;108:55-60. doi: 10.1016/j.sleep.2023.05.025. Epub 2023 Jun 8.
The co-occurrence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), known as COPD-OSA overlap syndrome, increases morbidity and mortality. The effectiveness of continuous positive airway pressure (CPAP) therapy, a commonly used treatment for OSA, in this patient population remains uncertain. Therefore, we conducted a systematic review to evaluate the efficacy of CPAP therapy in improving clinical outcomes.
We conducted a comprehensive systematic review to identify studies that evaluated the impact of CPAP therapy on COPD exacerbation, hospitalization, and mortality in patients with COPD-OSA overlap syndrome. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement and assessed the quality of each study using the Newcastle-Ottawa quality scale.
From the initial 3184 articles identified, we reviewed 365 and included five in the systematic review. Our findings revealed that CPAP therapy improved clinical outcomes, including COPD exacerbation, COPD related hospitalization, and mortality in patients with COPD-OSA overlap syndrome. However, the definition of COPD and OSA varied across studies, and the definition of CPAP usage was not consistent.
Our systematic review suggests that CPAP therapy is effective in improving outcomes in patients with COPD-OSA overlap syndrome. Nonetheless, further research is required to establish the efficacy of CPAP therapy by standardizing the definition of COPD, OSA, and CPAP usage.
阻塞性睡眠呼吸暂停（OSA）和慢性阻塞性肺疾病（COPD）的同时存在，即 COPD-OSA 重叠综合征，会增加发病率和死亡率。持续气道正压通气（CPAP）治疗作为 OSA 的常用治疗方法，在这一患者群体中的疗效仍不确定。因此，我们进行了一项系统评价，以评估 CPAP 治疗在改善临床结局方面的效果。
我们进行了全面的系统评价，以确定评估 CPAP 治疗对 COPD-OSA 重叠综合征患者 COPD 加重、住院和死亡率影响的研究。我们遵循系统评价和荟萃分析报告的首选报告项目，并使用纽卡斯尔-渥太华质量量表评估每项研究的质量。
从最初确定的 3184 篇文章中，我们回顾了 365 篇，并将其中 5 篇纳入系统评价。我们的研究结果表明，CPAP 治疗可改善 COPD-OSA 重叠综合征患者的临床结局，包括 COPD 加重、COPD 相关住院和死亡率。然而，研究中 COPD 和 OSA 的定义存在差异，CPAP 使用的定义也不一致。
我们的系统评价表明，CPAP 治疗在改善 COPD-OSA 重叠综合征患者的结局方面是有效的。然而，需要进一步的研究来通过标准化 COPD、OSA 和 CPAP 使用的定义来确定 CPAP 治疗的疗效。
