阻塞性睡眠呼吸暂停的呼吸道肌肉训练:系统审查和元分析
André Silva de Sousa1, Aline Pereira da Rocha1, Daniela Regina Brandão Tavares1
1Programa de Pós- Graduação em Saúde Baseada em Evidências, Universidad Federal de São Paulo, São Paulo, Brazil.
Journal of sleep research
|May 31, 2023
概括
呼吸道肌肉训练对阻塞性睡眠呼吸暂停 (OSA) 患者有潜在的益处,可能改善血压和嗜睡. 然而,其他结局的证据,如呼吸暂停-呼吸暂停指数仍然不确定,目前的研究中存在高偏差风险.
科学领域:
- 肺病学和呼吸系统医学
- 睡眠医学 睡眠医学
- 康复科学 康复科学 康复科学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是一种普遍存在的睡眠障碍,对健康有重大影响.
- 呼吸道肌肉训练 (RMT) 是作为OSA的非侵入性治疗方式进行的.
- 评估RMT在OSA患者的疗效和安全性对于临床实践至关重要.
研究的目的:
- 系统地审查呼吸器肌肉训练 (RMT) 对阻塞性睡眠呼吸暂停 (OSA) 的有效性和安全性.
- 评估呼吸和呼吸肌肉训练对OSA患者各种临床结果的影响.
- 评估OSARMT随机对照试验中的证据质量和偏差风险.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 在主要数据库 (MEDLINE,Embase,CENTRAL,LILACS,PEDro) 进行搜索,截至2022年7月.
- 包括13个RCT,评估所有纳入研究的偏差风险和证据确定性.
主要成果:
- 与假冒干预相比,鼓舞性肌肉训练 (IMT) 可能会改善缩血压和嗜睡.
- IMT对最大吸入压力和身体能力产生不确定的影响;对其他结果的证据有限或不确定.
- 呼吸道肌肉训练 (EMT) 可能会改善呼吸道肌肉强度和睡眠质量,但其对OSA严重性的影响尚不确定.
结论:
- 目前的证据表明,IMT可能为特定的OSA症状和心血管参数提供适度的益处,但偏差的高风险需要谨慎.
- 与运动或心脏康复相结合的RMT显示了潜在的协同效应,需要进一步调查.
- 需要更多高质量的RCT来确定RMT在治疗阻塞性睡眠呼吸暂停中的作用.
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