Obstructive Sleep Apnea and Oxygen Therapy: A Systematic Review of the Literature and Meta-Analysis

被引:80
作者
Mehta, Vanita [1 ]
Vasu, Tajender S. [2 ]
Phillips, Barbara [3 ]
Chung, Frances [1 ]
机构
[1] Univ Toronto, Toronto Western Hosp, Dept Anesthesiol, Univ Hlth Network, Toronto, ON M5T 2S8, Canada
[2] SUNY Stony Brook, Div Pulm Crit Care & Sleep Med, Stony Brook, NY 11794 USA
[3] Univ Kentucky, Coll Med, Div Pulm Crit Care & Sleep Med, Lexington, KY USA
来源
JOURNAL OF CLINICAL SLEEP MEDICINE | 2013年 / 9卷 / 03期
关键词
OSA; CPAP; oxygen therapy; POSITIVE AIRWAY PRESSURE; BLOOD-PRESSURE; SUPPLEMENTAL OXYGEN; POLYSOMNOGRAPHIC PREDICTORS; POSTOPERATIVE COMPLICATIONS; CARDIOVASCULAR-RESPONSES; MYOCARDIAL-INFARCTION; NOCTURNAL HYPOXEMIA; NASAL OXYGEN; CPAP;
D O I
10.5664/jcsm.2500
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Hypoxemia is an immediate consequence of obstructive sleep apnea. Oxygen (O-2) administration has been used as an alternative treatment in patients with obstructive sleep apnea (OSA) who do not adhere to continuous positive airway pressure (CPAP) in order to reduce the deleterious effects of intermittent hypoxemia during sleep. This systematic review aims to investigate the effects of O-2 therapy on patients with OSA. Method: We conducted a systematic search of the databases Medline, Embase, Cochrane Central Register of Controlled Trials (1st Quarter 2011), Cochrane Database of Systematic Reviews (from 1950 to February 2011). Our search strategy yielded 4,793 citations. Irrelevant papers were excluded by title and abstract review, leaving 105 manuscripts. We reviewed all prospective studies that included: (1) a target population with obstructive sleep apnea, (2) O-2 therapy and/or CPAP as a study intervention, (3) the effects of O-2 on the apnea-hypopnea index (AHI), nocturnal hypoxemia, or apnea duration. Results: We identified 14 studies including a total of 359 patients. Nine studies were of single cohort design, while 5 studies were randomized control trials with 3 groups (CPAP, oxygen, and placebo/sham CPAP). When CPAP was compared to O-2 therapy, all but one showed a significant improvement in AHI. Ten studies demonstrated that O-2 therapy improved oxygen saturation vs. placebo. However, the average duration of apnea and hypopnea episodes were longer in patients receiving O-2 therapy than those receiving placebo. Conclusion: This review shows that O-2 therapy significantly improves oxygen saturation in patients with OSA. However, it may also increase the duration of apnea-hypopnea events.
引用
收藏
页码:271 / 279
页数:9
相关论文
共 66 条
[1]   ACUTE OXYGEN IN PATIENTS WITH SLEEP-APNEA AND COPD [J].
ALFORD, NJ ;
FLETCHER, EC ;
NICKESON, D .
CHEST, 1986, 89 (01) :30-38
[2]   THE ACUTE EFFECTS OF CONTINUOUS POSITIVE AIRWAY PRESSURE AND OXYGEN ADMINISTRATION ON BLOOD-PRESSURE DURING OBSTRUCTIVE SLEEP-APNEA [J].
ALI, NJ ;
DAVIES, RJO ;
FLEETHAM, JA ;
STRADLING, JR .
CHEST, 1992, 101 (06) :1526-1532
[3]  
[Anonymous], 1980, ANN INTERN MED, V93, P391
[4]  
[Anonymous], 2010, SURGERY, DOI DOI 10.1016/J.SURG.2009.06.030
[5]  
[Anonymous], LEV EV
[6]  
[Anonymous], AM REV RESP DIS
[7]  
Bardwell Wayne A, 2007, Behav Sleep Med, V5, P21, DOI 10.1207/s15402010bsm0501_2
[8]   SNORING, NOCTURNAL HYPOXEMIA, AND THE EFFECT OF OXYGEN INHALATION [J].
BLOCK, AJ ;
HELLARD, DW ;
CICALE, MJ .
CHEST, 1987, 92 (03) :411-417
[9]   Sleep Apnea in Patients With Transient Ischemic Attack and Minor Stroke Opportunity for Risk Reduction of Recurrent Stroke? [J].
Chan, Wesley ;
Coutts, Shelagh B. ;
Hanly, Patrick .
STROKE, 2010, 41 (12) :2973-2975
[10]  
CHAUNCEY JB, 1990, SLEEP, V13, P167