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Published on: December 6, 2016
Maximizing outcomes by multimodal treatment in obstructive sleep apnea: a systematic review and meta-analysis
Andrea De Vito1, Aniello Donniacuo2, Giovanni Cammaroto3
1Department of Surgery, ENT Unit, Morgagni-Pierantoni Hospital, HLA of Romagna, Forlì, Italy. dr.andrea.devito@gmail.com.
Purpose:
This review aims to analyze the literature concerning multimodal treatments for Obstructive Sleep Apnea.
Methods:
The outcomes of interest were Apnea-Hypopnea Index (AHI) reduction, Epworth Sleepiness Scale (ESS) reduction and improved Continous Positive Airway Pressure (CPAP) treatment adherence. 47 studies were selected for the statistical analysis.
Results:
Related to the AHI reduction, the results showed a significantly greater reduction with multimodal interventions compared to single therapies (Z = -3.981; p < 0.05). For the ESS reduction, the overall effect size was -0.618 (Z = -2.464; p < 0.05), indicating that multimodal approaches provided a significantly greater reduction in ESS than single treatments. For the CPAP adherence the pooled effect size was 0.607 (Z = 2.341; p < 0.05) indicating that multimodal strategies significantly increased CPAP use compared to single treatments.
Conclusions:
Multimodal approaches for OSA patients represent a promising treatment strategy, highlighting the superiority of combined treatments over single strategy, and emphasizing the importance of a patient-tailored therapeutic decision-making process.
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