National Heart and Lung Institute, Imperial College London, London, UK
Department of Sleep and Ventilation, Royal Brompton Hospital, London, UK.
Thorax. 2023 Nov;78(11):1126-1134. doi: 10.1136/thorax-2021-218402. Epub 2023 Jun 21.
Vibrotactile positional therapy (PT) devices are a new treatment modality for positional obstructive sleep apnoea (POSA). This review aimed to determine the effect of vibrotactile PT on the Apnoea Hypopnoea Index (AHI) and the percentage of time spent in the supine position (%Tsupine) in patients with POSA, compared with baseline. Secondary aims were to investigate the effect on daytime sleepiness, quality of life and sleep quality.
A systematic review and meta-analysis was performed of randomised controlled trials (RCTs) and cohort studies that investigated the effect of vibrotactile PT in POSA patients. Searches were performed via MEDLINE, CENTRAL and Embase up to 29 October 2022.
1119 studies were identified, 18 studies met the inclusion criteria (10 RCTs, 8 cohort studies). The use of vibrotactile PT significantly reduced the AHI at follow-up compared with baseline (mean difference (95% CI) -9.19 events/hour (-11.68 to -6.70); p<0.00001). The mean %Tsupine was also significantly reduced (mean difference (95% CI) -32.79% (-38.75% to -26.83%); p<0.00001). The percentage changes in the AHI and %Tsupine were 43% and 70%, respectively. Secondary outcomes were daytime sleepiness, quality of life and sleep indices. These showed minimal change, although follow-up was short.
Vibrotactile PT devices are effective in treating POSA; reducing both AHI and %Tsupine. The effect on sleep quality, daytime sleepiness and disease-specific quality of life was minimal. However, there were limited data and follow-up was often brief, meaning that further research is needed to determine the effect of vibrotactile PT on patient-centred outcomes.
CRD42020188617.
振动体感疗法(PT)设备是治疗位置性阻塞性睡眠呼吸暂停(POSA)的一种新方法。本研究旨在确定与基线相比,振动体感 PT 对 POSA 患者的呼吸暂停低通气指数(AHI)和仰卧位时间百分比(%Tsupine)的影响。次要目标是研究其对日间嗜睡、生活质量和睡眠质量的影响。
通过 MEDLINE、CENTRAL 和 Embase 对截至 2022 年 10 月 29 日的随机对照试验(RCT)和队列研究进行了系统评价和荟萃分析,以调查振动体感 PT 在 POSA 患者中的效果。
共确定了 1119 项研究,18 项研究符合纳入标准(10 项 RCT,8 项队列研究)。与基线相比,振动体感 PT 的使用在随访时显著降低了 AHI(平均差值(95%CI)-9.19 次/小时(-11.68 至-6.70);p<0.00001)。仰卧位时间百分比也显著降低(平均差值(95%CI)-32.79%(-38.75%至-26.83%);p<0.00001)。AHI 和 %Tsupine 的百分比变化分别为 43%和 70%。次要结局为日间嗜睡、生活质量和睡眠指数。尽管随访时间较短,但这些结果显示变化很小。
振动体感 PT 设备治疗 POSA 有效;降低 AHI 和 %Tsupine。对睡眠质量、日间嗜睡和特定疾病的生活质量影响很小。然而,数据有限,随访时间通常较短,因此需要进一步研究以确定振动体感 PT 对患者为中心结局的影响。
PROSPERO 注册号:CRD42020188617。