Correa Eduardo J, Conti Diego M, Gozal David, O'Connor-Reina Carlos
Otorhinolaryngology Department, Hospital La Linea de la Concepción, Cadiz España.
The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium.
Sleep. 2024 Dec 11;47(12). doi: 10.1093/sleep/zsae164.
The purpose of this systematic review is to evaluate the modifiable risk factors associated with obstructive sleep apnea (OSA) and analyze extant publications solely focused on prevention of the disease.
Studies focused on prevention strategies for OSA and modifiable risk factors were eligible for inclusion. A detailed individual search strategy for each of the following bibliographic databases was developed: Cochrane, EMBASE, MEDLINE, PubMed, and LILACS. The references cited in these articles were also crosschecked and a partial gray literature search was undertaken using Google Scholar. The methodology of selected studies was evaluated using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies.
Search resulted in 720 publications examining risk factors and prevention of OSA, as well as lifestyle modifications. Of these, a thorough assessment of the abstracts and content of each of these manuscripts led to the rejection of all but four papers, the latter being included in this systematic review. In contrast, a search regarding "Therapeutics" showed that 23 674 articles on OSA were published, clearly illustrating the imbalance between the efforts in prevention and those focused on therapeutics.
Notwithstanding the importance and benefits of technological advances in medicine, consideration of the needs of people with OSA and its consequences prompts advocacy for the prevention of the disease. Thus, despite the economic interests that focus only on diagnosis and treatment, strategies preferentially aimed at overall avoidance of OSA emerge as a major priority. Thus, public and healthcare provider education, multidimensional prevention, and early diagnosis of OSA should be encouraged worldwide.
本系统评价的目的是评估与阻塞性睡眠呼吸暂停（OSA）相关的可改变风险因素，并分析仅专注于该疾病预防的现有出版物。
聚焦于OSA预防策略和可改变风险因素的研究符合纳入标准。针对以下每个书目数据库制定了详细的单独检索策略：Cochrane、EMBASE、MEDLINE、PubMed和LILACS。还对这些文章中引用的参考文献进行了交叉核对，并使用谷歌学术进行了部分灰色文献检索。使用诊断准确性研究的14项质量评估工具对所选研究的方法进行评估。
检索结果为720篇研究OSA风险因素、预防以及生活方式改变的出版物。其中，对每篇手稿的摘要和内容进行全面评估后，除了4篇论文外，其余均被排除，这4篇论文被纳入本系统评价。相比之下，关于“治疗学”的检索显示，发表了23674篇关于OSA的文章，清楚地说明了预防和治疗方面的研究力度失衡。
尽管医学技术进步具有重要意义和益处，但考虑到OSA患者的需求及其后果，倡导预防该疾病是必要的。因此，尽管存在仅关注诊断和治疗的经济利益，但优先旨在全面避免OSA的策略仍是主要优先事项。因此，应在全球范围内鼓励对公众和医疗服务提供者进行教育、开展多维度预防以及对OSA进行早期诊断。
