Zeng Ziqian, Yang Yanan, Zhang Yuewen, Wu Xiuming, Chen Weizhong, Gu Dongqing
First Affiliated Hospital, Army Medical University, Chongqing, 400038 China.
Department of Epidemiology and Statistics, Chengdu Medical College, Chengdu, Sichuan China.
Sleep Biol Rhythms. 2022 May 18;20(4):473-480. doi: 10.1007/s41105-022-00391-8. eCollection 2022 Oct.
Antihypertensive medication is an effective way to control blood pressure. However, some studies reported that it may affect patients' sleep quality during the treatment. Due to the inconsistency of present results, a comprehensive systematic review and network meta-analysis are needed.
Electronic databases (MEDLINE, EMBASE, WEB OF SCIENCE, PUBMED) were searched up to April 10th, 2021 including no restriction of publication status. Randomized controlled trials (RCTs) or quasi-experimental studies or cohort studies were eligible. The network meta-analysis was used within a Bayesian framework.
Finally, 16 publications (including 12 RCTs and 4 quasi-experimental studies) with 404 subjects were included in this study. Compared to placebo, the results of the network meta-analysis showed that diuretics were effective in improving sleep apnea with a mean difference (MD) of - 15.47 (95% confidence interval [CI]: - 23.56, - 6.59) which was consistent with the direct comparison result (MD: - 17.91; 95% CI - 21.60, - 14.23). In addition, diuretics were effective in increasing nocturnal oxygen saturation with an MD of 3.64 (95% CI 0.07, 7.46). However, the effects of β-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and the others on sleep apnea were not statistically significant. Additionally, the effects of antihypertensive medication on the total sleep time (min), rapid eye movement (%), and sleep efficiency (%) were not statistically significant.
Our study found that diuretics could effectively reduce the severity of sleep apnea in hypertensive patients. However, the effects of antihypertensive drugs on sleep characteristics were not found.
The online version contains supplementary material available at 10.1007/s41105-022-00391-8.
抗高血压药物是控制血压的有效方法。然而，一些研究报告称，在治疗过程中它可能会影响患者的睡眠质量。由于目前结果不一致，需要进行全面的系统评价和网状Meta分析。
检索截至2021年4月10日的电子数据库（MEDLINE、EMBASE、科学网、PubMed），不限出版状态。随机对照试验（RCT）、准实验研究或队列研究均符合要求。在贝叶斯框架内进行网状Meta分析。
本研究最终纳入16篇文献（包括12项RCT和4项准实验研究），共404名受试者。与安慰剂相比，网状Meta分析结果显示，利尿剂在改善睡眠呼吸暂停方面有效，平均差（MD）为-15.47（95%置信区间[CI]：-23.56，-6.59），这与直接比较结果一致（MD：-17.91；95%CI -21.60，-14.23）。此外，利尿剂在提高夜间血氧饱和度方面有效，MD为3.64（95%CI 0.07，7.46）。然而，β受体阻滞剂、钙通道阻滞剂、血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂及其他药物对睡眠呼吸暂停的影响无统计学意义。此外，抗高血压药物对总睡眠时间（分钟）、快速眼动（%）和睡眠效率（%）的影响无统计学意义。
我们的研究发现，利尿剂可有效降低高血压患者睡眠呼吸暂停的严重程度。然而，未发现抗高血压药物对睡眠特征的影响。
在线版本包含可在10.1007/s41105-022-00391-8获取的补充材料。
