Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Both authors contributed equally to this work.
Eur Respir Rev. 2024 Mar 20;33(171). doi: 10.1183/16000617.0173-2023. Print 2024 Jan 31.
Obstructive sleep apnoea is characterised by recurrent reduction of airflow during sleep leading to intermittent hypoxia. Continuous positive airway pressure is the first-line treatment but is limited by poor adherence. Nocturnal oxygen therapy may be an alternative treatment for obstructive sleep apnoea but its effects remain unclear. This meta-analysis evaluates the effects of nocturnal oxygen therapy on both obstructive sleep apnoea severity and blood pressure.A literature search was performed based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Peer-reviewed, randomised studies that compared the effect of nocturnal oxygen therapy to sham in obstructive sleep apnoea patients were included. The main outcomes were the apnoea-hypopnoea index and systolic and diastolic blood pressure.The search strategy yielded 1295 citations. Nine studies with 502 participants were included. When nocturnal oxygen therapy was compared to sham/air, it significantly reduced the apnoea-hypopnoea index (mean difference (MD) -15.17 events·h, 95% CI -19.95- -10.38 events·h, p<0.00001). Nocturnal oxygen therapy had no significant effect on blood pressure at follow-up without adjustment for baseline values, but did, where available, significantly attenuate the change in blood pressure from baseline to follow-up for both systolic blood pressure (MD -2.79 mmHg, 95% CI -5.45- -0.14 mmHg, p=0.040) and diastolic blood pressure (MD -2.20 mmHg, 95% CI -3.83- -0.57 mmHg, p=0.008).Nocturnal oxygen therapy reduced the apnoea-hypopnoea index severity and the change in (but not absolute) systolic and diastolic blood pressure, compared to sham. This suggests that nocturnal oxygen therapy may be a treatment option for obstructive sleep apnoea. Further studies with longer-term follow-up and standardised measurements are needed.
阻塞性睡眠呼吸暂停的特征是睡眠期间气流反复减少，导致间歇性缺氧。持续气道正压通气是一线治疗方法，但由于顺应性差而受到限制。夜间氧疗可能是阻塞性睡眠呼吸暂停的替代治疗方法，但疗效仍不清楚。本荟萃分析评估了夜间氧疗对阻塞性睡眠呼吸暂停严重程度和血压的影响。
文献检索根据系统评价和荟萃分析的首选报告项目进行。纳入了比较夜间氧疗与阻塞性睡眠呼吸暂停患者假治疗效果的同行评议、随机研究。主要结局是呼吸暂停低通气指数和收缩压及舒张压。
搜索策略产生了 1295 条引文。纳入了 9 项研究，共 502 名参与者。与假/空气相比，夜间氧疗可显著降低呼吸暂停低通气指数（平均差异（MD）-15.17 次·h，95%CI-19.95-10.38 次·h，p<0.00001）。在未调整基线值的情况下，夜间氧疗对血压的随访无显著影响，但在有数据的情况下，显著减轻了从基线到随访期间血压的变化，收缩压（MD-2.79mmHg，95%CI-5.45-0.14mmHg，p=0.040）和舒张压（MD-2.20mmHg，95%CI-3.83-0.57mmHg，p=0.008）。
与假治疗相比，夜间氧疗降低了呼吸暂停低通气指数严重程度和（但不是绝对的）收缩压和舒张压的变化。这表明夜间氧疗可能是阻塞性睡眠呼吸暂停的一种治疗选择。需要进行更多具有更长随访时间和标准化测量的研究。
