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Nicotine & Tobacco Research : Official... Feb 2023To systematically review the association between smoking behavior and obstructive sleep apnea (OSA). (Meta-Analysis)
Meta-Analysis
INTRODUCTION
To systematically review the association between smoking behavior and obstructive sleep apnea (OSA).
AIMS AND METHODS
PubMed, Medline, the Cochrane Library, EMBASE, and Scopus databases were used to conduct this review. The two researchers independently screened the literatures, conducted the quality assessment, and data extraction according to the inclusion and exclusion criteria. The RevMan 5.3 was used to analysis the apnea hypopnea index (AHI) index, min saturation of oxyhemoglobin (SaO2), Epworth Sleepiness Scale (ESS) score, and oxygen desaturation index (DOI) and publication bias analysis to assess the effect of smoking on OSA patients. Furthermore, we performed subgroup of the severity of OSA, different countries of sample origin (western countries or eastern countries), and pack-years (PYs < 10 or PYs ≥ 20) to analyze the heterogeneity.
RESULTS
Thirteen studies were included in this analysis that conformed to inclusion criteria and exclusion criteria. Totally 3654 smokers and 9796 non-smokers have participated. The meta-analysis of 13 studies demonstrated that AHI levels were significantly higher in smoker group compared with non-smoker, ESS scores were also significantly higher in smoker group compared with non-smoker, min SaO2 levels were obviously lower in smoker group compared with non-smoker, however, DOI levels hadn't significantly different between two groups. The subgroup analysis showed that there was an association between severe OSA, eastern countries, pack-years, and smoking.
CONCLUSIONS
Smoking behavior is a significant association with OSA. Heavy smokers with histories of more than 20 PYs were at a higher risk of OSA. Moreover, patient with severe OSA exhibited a significantly association with smoking compared with patients with mild or moderate OSA.
IMPLICATIONS
The relationship between smoking and OSA was controversial, especially, whether smoking increase or aggravate the risk of OSA. In our review and meta-analysis, we demonstrated that smoking behavior is a significant association with OSA. Heavy smokers with histories of more than 20 PYs were at a higher risk of OSA. Moreover, patient with severe OSA exhibited a significant association with smoking compared with patients with mild or moderate OSA. More prospective long-term follow-up studies about effect of quit smoking on OSA are recommended to establish the further relationship.
Topics: Humans; Smoking; Prospective Studies; Sleep Apnea, Obstructive; Tobacco Smoking; Non-Smokers
PubMed: 35922388
DOI: 10.1093/ntr/ntac126 -
Journal of Diabetes Investigation Aug 2022Obstructive sleep apnea (OSA) is related to prediabetes and diabetes. Whether patients with OSA have a higher risk of prediabetes/diabetes remains unclear. We aimed to... (Meta-Analysis)
Meta-Analysis
AIMS/INTRODUCTION
Obstructive sleep apnea (OSA) is related to prediabetes and diabetes. Whether patients with OSA have a higher risk of prediabetes/diabetes remains unclear. We aimed to carry out a meta-analysis of published studies to evaluate the relationships between OSA and prediabetes and diabetes, and the impact of the severity of OSA on diabetes.
MATERIALS AND METHODS
The PubMed, EMBASE and Cochrane databases were searched from January 2011 to July 2021. The associations between OSA and impaired fasting glucose, impaired glucose tolerance, impaired glucose regulation and diabetes mellitus were analyzed. We estimated the pooled odds ratios using fixed or random effects models. We included 25 studies comprising a total of 154,948 patients with OSA and risk factors for prediabetes/diabetes (20 and 16, respectively) in the analysis.
RESULTS
OSA was associated with a higher risk of impaired fasting glucose, impaired glucose tolerance, impaired glucose regulation and diabetes mellitus in the cohort studies and cross-sectional studies. The pooled odds ratios were 2.34 (95% confidence interval [CI] 1.16-4.72), 1.58 (95% CI 1.15-2.15), 1.65 (95% CI 1.12-2.42), 2.15 (95% CI 1.68-2.75) and 3.62 (95% CI 2.75-4.75), respectively. Subgroup analyses were based on the proportions of men and women. The results showed that OSA was a risk factor, and there was no significant difference between the two groups. The risk of diabetes increased with the severity of OSA.
CONCLUSIONS
The risk of developing prediabetes and diabetes was higher in patients with OSA.
Topics: Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Glucose; Glucose Intolerance; Humans; Male; Prediabetic State; Sleep Apnea, Obstructive
PubMed: 35302714
DOI: 10.1111/jdi.13793 -
Sleep Oct 2013Obstructive sleep apnea (OSA) is a common sleep disorder associated with several adverse health outcomes. Given the close association between OSA and obesity, lifestyle... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Obstructive sleep apnea (OSA) is a common sleep disorder associated with several adverse health outcomes. Given the close association between OSA and obesity, lifestyle and dietary interventions are commonly recommended to patients, but the evidence for their impact on OSA has not been systematically examined.
OBJECTIVES
To conduct a systematic review and meta-analysis to assess the impact of weight loss through diet and physical activity on measures of OSA: apnea-hypopnea index (AHI) and oxygen desaturation index of 4% (ODI4).
METHODS
A systematic search was performed to identify publications using Medline (1948-2011 week 40), EMBASE (from 1988-2011 week 40), and CINAHL (from 1982-2011 week 40). The inverse variance method was used to weight studies and the random effects model was used to analyze data.
RESULTS
Seven randomized controlled trials (519 participants) showed that weight reduction programs were associated with a decrease in AHI (-6.04 events/h [95% confidence interval -11.18, -0.90]) with substantial heterogeneity between studies (I(2) = 86%). Nine uncontrolled before-after studies (250 participants) showed a significant decrease in AHI (-12.26 events/h [95% confidence interval -18.51, -6.02]). Four uncontrolled before-after studies (97 participants) with ODI4 as outcome also showed a significant decrease in ODI4 (-18.91 episodes/h [95% confidence interval -23.40, -14.43]).
CONCLUSIONS
Published evidence suggests that weight loss through lifestyle and dietary interventions results in improvements in obstructive sleep apnea parameters, but is insufficient to normalize them. The changes in obstructive sleep apnea parameters could, however, be clinically relevant in some patients by reducing obstructive sleep apnea severity. These promising preliminary results need confirmation through larger randomized studies including more intensive weight loss approaches.
Topics: Diet, Reducing; Humans; Motor Activity; Risk Reduction Behavior; Sleep Apnea, Obstructive; Treatment Outcome; Weight Loss
PubMed: 24082315
DOI: 10.5665/sleep.3056 -
Sleep Feb 2016This systematic review aims to investigate the association between obstructive sleep apnea (OSA) and diabetic kidney disease (DKD). (Meta-Analysis)
Meta-Analysis Review
STUDY OBJECTIVE
This systematic review aims to investigate the association between obstructive sleep apnea (OSA) and diabetic kidney disease (DKD).
METHODS
MeSH terms and free text searches were performed on MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception to April 2015. Zetoc and OpenGrey databases were queried for grey literature, and lastly, hand searches were carried out. Study selection and quality assessment were conducted by two authors. One author carried out data extraction, which was checked by other authors. The relationships between apneahypopnea index (AHI), oxygen desaturation index (ODI), time spent under 90% oxygen saturation (%TST < 90), and minimum and mean oxygen saturation (O2) on DKD were examined.
RESULTS
Two longitudinal and ten cross-sectional studies were included for our narrative synthesis, and seven studies for meta-analysis. Studies that performed multi-variable analysis demonstrated significant associations between OSA (assessed using either apnea-hypopnea index or ODI) and DKD in type 2 diabetes mellitus (T2DM). This was confirmed by meta-analysis (pooled OR 1.73, 95% CI: 1.13-2.64). There was some evidence to suggest that %TST < 90 may have an association with DKD. There was insufficient evidence to conclude on the relationship between minimum and mean oxygen saturation on DKD. There was no evidence available on the associations between OSA and other respiratory parameters in type 1 diabetes mellitus populations.
CONCLUSIONS
There is moderate evidence that OSA is associated with DKD in patients with T2DM. Large prospective studies with long-term follow up are needed to assess the possible bi-directional mechanisms between OSA and DKD.
Topics: Cross-Sectional Studies; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Humans; Longitudinal Studies; Oxygen; Sleep Apnea, Obstructive
PubMed: 26414891
DOI: 10.5665/sleep.5432 -
Sleep Medicine Jun 2024This systematic review and meta-analysis investigates the relationship between haemoglobin (Hb) concentrations and obstructive sleep apnea syndrome (OSAS).
BACKGROUND
This systematic review and meta-analysis investigates the relationship between haemoglobin (Hb) concentrations and obstructive sleep apnea syndrome (OSAS).
METHODS
Following PRISMA guidelines, we searched PubMed, EMBASE, and Cochrane Library from inception to March 8, 2024. Eligible studies included cross-sectional, cohort, and case-control designs comparing Hb concentrations in OSAS patients and healthy controls. Two reviewers independently screened records and extracted data. The risk of bias was assessed using the Joanna Briggs Institute checklist.
RESULTS
A total of 27 studies involving 6499 OSAS subjects and 5199 controls were included. Hb concentrations were significantly higher in OSAS patients compared to controls (SMD: 0.28; 95 % CI: 0.18 to 0.39; I = 84.4 %). Subgroup analysis by OSAS severity showed that severe OSAS patients had higher Hb concentrations than those with mild/moderate OSAS. Sensitivity analyses confirmed the robustness of the findings. However, 7 studies reported opposite results, indicating possible regional or methodological differences.
CONCLUSION
Hb concentrations are elevated in OSAS patients, with higher levels observed in severe cases. The significant heterogeneity and the predominance of studies from Turkey highlight the need for further research in diverse populations. Limitations include potential publication bias and variability in study designs.
PubMed: 38917721
DOI: 10.1016/j.sleep.2024.06.018 -
Journal of Current Glaucoma Practice 2021Obstructive sleep apnea (OSA) is a known systemic risk factor associated with glaucoma. The purpose of the study was to determine the overall prevalence of sleep apnea...
AIM AND OBJECTIVE
Obstructive sleep apnea (OSA) is a known systemic risk factor associated with glaucoma. The purpose of the study was to determine the overall prevalence of sleep apnea among patients with glaucoma.
DESIGN
A systematic review and meta-analysis.
PARTICIPANTS
Not applicable.
MATERIALS AND METHODS
A systematic literature search was performed through MEDLINE, EMBASE, and CINAHL and gray literature using Clinical Trials.gov, and ProQuest Dissertations and Theses and conferences held through the Association for Research in Vision and Ophthalmology, American Academy of Ophthalmology, and Canadian Society of Ophthalmology was done until June 10, 2020. Eligible articles were identified by reviewing the retrieved results. Data extracted included the total number of patients with glaucoma and the proportion of glaucoma patients with a co-occurring diagnosis of OSA. STATA 15.0 was used to perform the meta-analysis.
RESULTS
544 articles were gathered from the databases and 40 records were collected via the gray literature search. Ten studies with 956 subjects were included for analysis. The results of the meta-analysis demonstrated a significant rate of OSA among glaucoma patients (ES = 0.17; CI: [0.08, 0.25]).
CONCLUSION
We examine the prevalence of OSA in glaucoma patients and conclude that the prevalence of OSA in glaucoma patients is higher.
CLINICAL SIGNIFICANCE
The findings in the ongoing investigation on the link between glaucoma and OSA continue to be unclear. The results from this study contribute to evidence of an association between the two diseases.
HOW TO CITE THIS ARTICLE
Yu BE, Cheung R, Hutnik C, Prevalence of Obstructive Sleep Apnea in Glaucoma Patients: A Systematic Review and Meta-analysis. J Curr Glaucoma Pract 2021;15(3):109-116.
PubMed: 35173392
DOI: 10.5005/jp-journals-10078-1301 -
Medicina (Kaunas, Lithuania) Sep 2022Background and objective: Among the broad variety of chemokines, monocyte chemoattractant protein-1 (MCP-1) is considered to be one of the most important chemokines.... (Meta-Analysis)
Meta-Analysis Review
Background and objective: Among the broad variety of chemokines, monocyte chemoattractant protein-1 (MCP-1) is considered to be one of the most important chemokines. Among others, MCP-1 activates monocytes and other immune cells highly involved in inflammation. In the present systematic review and meta-analysis, we evaluated the relationship between serum/plasma MCP-1 levels and the risk of obstructive sleep apnea (OSA) in adults as a disease related to inflammation. Materials and methods: Four databases were systematically investigated until 12 July 2022. We used the Review Manager 5.3 software (Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) to extract and calculate the standardized mean difference (SMD) and its 95% confidence interval (CI) of plasma/serum levels of MCP-1 between adults with and without OSA. Results: Eight articles including eleven studies in adults were entered into the meta-analysis. The serum/plasma MCP-1 levels in adults with OSA were higher than that in the controls (SMD = 0.81; p = 0.0007) and as well as for adults with severe OSA compared to those with mild and moderate OSA (SMD = 0.42; p < 0.0001). The subgroup analysis showed that ethnicity was an effective factor in the pooled analysis of blood MCP-1 levels in adults with OSA compared to the controls (Asians: (p < 0.0001), mixed ethnicity: (p = 0.04), and Caucasians: (p = 0.89)). The meta-regression showed increasing serum/plasma MCP-1 levels in adults with OSA versus the controls, publication year, age of controls, body mass index (BMI) of controls, and sample size reduced, and also BMI and the apnea−hypopnea index of adults with OSA increased. Conclusions: The meta-analysis showed that compared to the controls, serum/plasma levels of MCP-1 in adults with OSA were significantly more, as well as adults with severe OSA having more serum/plasma MCP-1 levels compared to the adults with mild to moderate OSA. Therefore, MCP-1 can be used as a diagnostic and therapeutic factor in adults with OSA.
Topics: Adult; Chemokine CCL2; Humans; Inflammation; Monocytes; Sleep Apnea, Obstructive
PubMed: 36143943
DOI: 10.3390/medicina58091266 -
Systematic Reviews Jul 2021We aimed to perform a systematic review and meta-analysis of the association between obstructive sleep apnea (OSA) and cardiac as well as coronary impairment evaluated... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
We aimed to perform a systematic review and meta-analysis of the association between obstructive sleep apnea (OSA) and cardiac as well as coronary impairment evaluated using imaging modalities. Finding of this study will provide more robust evidence regarding OSA-induced cardiovascular damage.
METHODS
We systematically searched through PubMed, EMBASE, and Cochrane library databases for relevant literatures on the association between OSA and cardiovascular damage evaluated using imaging modalities, and manually searched the references of selected articles for additional relevant articles. For each clinical parameter relevant to the meta-analysis, we first evaluated the methodological heterogeneity of the relevant studies and thereafter pooled the data together using fixed effect or random effect model. The difference in the relevant indices of cardiovascular damage between OSA patients and controls was evaluated using the standardized mean difference.
RESULTS
Of the 82 articles included in the final systematic analysis, 20 studies explored the association between OSA and coronary atherosclerosis. OSA patients had higher rate of coronary atherosclerosis assessed by coronary artery calcification score and plaque volume. Moreover, the severity of OSA and coronary atherosclerosis displayed a positive correlation. The rest of the studies (n = 62) evaluated cardiac alterations in OSA patients. According to the inclusion and exclusion criteria, 46 studies yielding 3082 OSA patients and 1774 controls were pooled for the meta-analysis. For left cardiac structure and function, OSA patients exhibited significantly wider left atrial diameter; higher left atrium volume index; wider left ventricular end-systolic diameter, left ventricular end-diastolic diameter, and left ventricular mass; higher left ventricular mass index; wider interventricular septum diameter and posterior wall diameter; and higher left ventricular myocardial performance index (all p < 0.05). In addition, compared with controls, left ventricular ejection fraction was significantly decreased in OSA patients (p = 0.001). For right cardiac structure and function, OSA patients displayed a significant increase in right ventricular diameter and right ventricular myocardial performance index (both p < 0.001). Finally, compared with controls, OSA patients displayed significant decrease in tricuspid annular plane systolic excursion and RV fractional area change (p = 0.001).
CONCLUSION
Overall, this systematic review and meta-analysis provides imaging evidence in support that OSA patients are at a higher risk of developing coronary atherosclerosis and display cardiac remodeling and dysfunction.
Topics: Diagnostic Imaging; Humans; Sleep Apnea, Obstructive; Stroke Volume; Ventricular Function, Left
PubMed: 34330323
DOI: 10.1186/s13643-021-01759-6 -
Scientific Reports Apr 2020The link between psoriasis and obstructive sleep apnea (OSA) has not been confirmed. We aimed to investigate the relationship between psoriasis and OSA. We conducted a... (Meta-Analysis)
Meta-Analysis
The link between psoriasis and obstructive sleep apnea (OSA) has not been confirmed. We aimed to investigate the relationship between psoriasis and OSA. We conducted a systematic review and meta-analysis of case-control, cross-sectional, and cohort studies on the association between psoriasis and OSA. We searched MEDLINE and Embase for relevant studies on May 11, 2019. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of included studies. We performed random-effects model meta-analysis to calculate pooled odds ratio (ORs) with 95% confidence intervals (CIs) for case-control and cross-sectional studies as well as pooled incidence rate ratio (IRR) with 95% CIs for cohort studies in association between psoriasis and OSA. A total of 4 case-control or cross-sectional studies and 3 cohort studies with a total of 5,840,495 subjects were included. We identified a significantly increased odds for OSA in psoriasis patients (pooled OR 2.60; 95% CI 1.07-6.32), and significantly increased risk for psoriasis in OSA patients (pooled IRR 2.52; 95% CI 1.89-3.36). In conclusion, our study identified a bidirectional association between psoriasis and OSA. Sleep quality should be inquired in patients with psoriasis. Respirologist consultation or polysomnography may be indicated for those presenting with night snoring, recurrent awaking, and excessive daytime sleepiness.
Topics: Animals; Humans; Incidence; Psoriasis; Risk; Sleep Apnea, Obstructive
PubMed: 32246124
DOI: 10.1038/s41598-020-62834-x -
Antioxidants (Basel, Switzerland) Jun 2021Oxidative stress induced by nocturnal intermittent hypoxia plays a significant pathophysiological role in obstructive sleep apnea (OSA). Malondialdehyde (MDA), one of... (Review)
Review
Oxidative stress induced by nocturnal intermittent hypoxia plays a significant pathophysiological role in obstructive sleep apnea (OSA). Malondialdehyde (MDA), one of the most commonly investigated markers of lipid peroxidation, might assist with the monitoring of oxidative balance in OSA. We conducted a systematic review and meta-analysis to evaluate the differences in circulating MDA concentrations between patients with OSA and non-OSA controls. A systematic search was conducted in the electronic databases Pubmed, Web of Science, Scopus and Google Scholar from inception to December 2020 by using the following terms: "malondialdehyde" or "MDA"; and "Obstructive Sleep Apnea Syndrome", "OSAS" or "OSA". We identified 26 studies in 1223 OSA patients and 716 controls. The pooled MDA concentrations were significantly higher in patients with OSA (standardized mean difference (SMD) 1.43 μmol/L, 95% confidence interval (CI) 1.03 to 1.83 μmol/L, < 0.001). There was extreme heterogeneity between the studies (I = 92.3%, < 0.001). In meta-regression analysis, the SMD was significantly associated with age, the assay type used and publication year. In our meta-analysis, MDA concentrations were significantly higher in OSA patients than in controls. This finding suggests that MDA, which is a marker of lipid peroxidation, is involved in the pathogenesis of OSA and provides insights for future studies investigating its potential clinical use.
PubMed: 34210032
DOI: 10.3390/antiox10071053