The effect of non-benzodiazepine sedative hypnotics on CPAP adherence in patients with OSA: a systematic review and meta-analysis

被引:11
|
作者
Wang, Donghao [1 ]
Tang, Yongkang [1 ]
Chen, Yanghang [1 ]
Zhang, Sun [1 ]
Ma, Danjie [1 ]
Luo, Yateng [1 ]
Li, Shiwei [1 ]
Su, Xiaofen [1 ]
Wang, Xinni [1 ]
Liu, Chunli [1 ]
Zhang, Nuofu [1 ]
机构
[1] Guangzhou Med Univ, Affiliated Hosp 1, Natl Clin Res Ctr Resp Dis, Guangzhou Inst Resp Hlth,State Key Lab Resp Dis, Guangzhou, Guangdong, Peoples R China
关键词
obstructive sleep apnea; non-benzodiazepine sedative hypnotics; CPAP; adherence; eszopiclone; zolpidem; zaleplon; POSITIVE AIRWAY PRESSURE; OBSTRUCTIVE SLEEP-APNEA; MOTIVATIONAL ENHANCEMENT; INCREASING ADHERENCE; PUBLICATION BIAS; DOUBLE-BLIND; ESZOPICLONE; TITRATION; ZOLPIDEM; EDUCATION;
D O I
10.1093/sleep/zsab077
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Objectives: This meta-analysis aimed to explore the effect of non-benzodiazepine sedative hypnotics (NBSH) on continuous positive airway pressure (CPAP) adherence in patients with obstructive sleep apnea (OSA). Methods: We conducted a systematic search through PubMed, Medline, the Cochrane Library, EMBASE, Scopus and ClinicalTrials (all searched from inception to August 15, 2020). Publications were limited to articles, clinical conferences and letters, including randomized controlled trials and retrospective studies. We used a random-effects model to calculate the odds ratio (OR) and mean difference (MD) with corresponding confidence interval (CI). Subgroup analyses were conducted to analyze the sources of heterogeneity. Results: Eight studies fulfilled the inclusion and exclusion criteria for patients newly diagnosed with obstructive sleep apnea. Overall, the use of NBSH was associated with increased use of CPAP per night (MD = 0.62 h; 95% CI = 0.26-0.98) and use for more nights (MD = 12.08%; 95% CI = 5.27-18.88). When a study seriously affecting heterogeneity was removed, more patients adhered well with CPAP use (pooled OR = 2.48; 95% CI = 1.75-3.52) with good adherence defined as CPAP use for >4 h/night on >70% of nights. Among prescribed NBSHs, eszopiclone showed the most significant effect on CPAP adherence. Conclusion: CPAP adherence may increase in OSA patients treated with non-benzodiazepine sedative hypnotics especially eszopiclone. The effect of zolpidem and zaleplon on CPAP adherence requires further investigation by larger scale, randomized, controlled trials.
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页数:11
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