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针对睡眠呼吸暂停的成年人进行非药物干预的比较有效性:系统性审查和网络元分析

Spyridon N Papageorgiou¹, Ioannis Konstantinidis², Alexandra K Papadopoulou³

¹Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland.

|February 11, 2025

概括

阳性气道压力 (PAP) 是阻塞性睡眠呼吸暂停 (OSA) 最有效的治疗方法,可以改善症状和生活质量. 部推进装置 (MAD) 为那些不能容忍PAP的人提供了替代方案,尽管效益较小.

科学领域:

睡眠医学睡眠医学
呼吸系统医学呼吸系统医学
心血管健康心血管健康

背景情况:

睡眠呼吸暂停显著影响心血管健康,生产力和生活质量.
睡眠呼吸暂停的最佳非药物治疗策略仍然不确定.
本综述侧重于评估成人睡眠呼吸暂停的各种非药物干预措施.

研究的目的:

系统地审查成年人睡眠呼吸暂停的非药物干预措施的疗效.
使用网络元分析,比较睡眠呼吸暂停的不同治疗方法的有效性.
根据呼吸暂停的严重程度和患者的耐受性来确定最佳的治疗选择.

主要方法:

随机试验的系统审查和频率网络元分析.
在 MEDLINE,Scopus,虚拟健康图书馆和 Web-of-Science 搜索到 2023 年 6 月.
包括197项试验 (15,931名患者) 评估25种不同的睡眠呼吸暂停治疗方法.

主要成果:

阳性气道压力 (PAP) 疗法在改善呼吸暂停-呼吸暂停指数,白天嗜睡和阻塞性睡眠暂停 (OSA) 患者的生活质量方面表现出卓越的疗效.
部推进装置 (MAD) 对抑郁和呼吸暂停的结果显著改善,特别是在轻度至中度病例中,但效果不如PAP.
其他干预措施 (如针,健康行为修改和手术) 的证据很弱;电神经刺激对中枢睡眠呼吸暂停有希望.

结论:

PAP治疗是所有严重程度的成年OSA最有效的治疗方法.
对于不耐受PAP的患者来说,MAD是可行的替代品,提供适度的益处.
治疗的坚持和患者特异性反应使睡眠呼吸暂停的管理变得复杂.

关键词:

呼吸暂停 (apnea) 是一种进行元分析分析.随机对照试验是随机对照试验.睡眠呼吸暂停综合征是什么系统性审查系统性审查

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