Effectiveness Of Continuous Positive Airway Pressure In Treating Patients With Moderate To Severe Obstructive Sleep Apnea-hypopnea Syndrome:a Meta-analysis

Objective To assess the effect of continuous positive airway pressure treatment(CPAP)in patients with moderate to severe obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods The following databases including The Cochrane Library、Pub Med、EMbase、CBM、CNKI and Wan Fang Data were searched from inception to April 01,2016.The randomized controlled trials(RCTs)were collected which studied the treatment of CPAP on patients with OSAHS.The relevant conference proceedings were also retrieved which were unpublished.And all the articles were retrieved without limitation of type and publication time.We chose the literatures that divided patients randomly into two groups as CPAP group and blank control group(conventional therapy、conservative treatment、placebo treatment and sham CPAP).In accordance with the inclusion and exclusion criteria,two reviewers independently screened studies,extracted effective data,and evaluated the quality.And then meta-analysis was performed by means of Rev Man 5.3 software and Stata12.0 software.Results Totally 14 RCTs were involved,including 1327 patients,which involved 12 random parallel controlled trials and 2 random crossover controlled trials.A Meta-analysis showed that: The therapeutical effect on depressed the degree of sleepiness in ESS and apnea-hypopnea index(AHI)in CPAP treatment group were all significantly higher than those in the control group(P<0.00001).The data were WMD=-3.02,95%CI-4.40 to-1.64,P<0.00001 and WMD=-29.86,95%CI-35.21 to-24.51,P<0.000 01 respectively.Conclusions CPAP is a valuable treatment for OSAHS no matter in subjective or objective sleepiness.More high-quality RCTs need to be conducted in order to explore the conclusion further with the limitation of quantity and quality among the adopted studies.In addition,the differences of curative effect of the length of treatment time and the concurrence of symptom of sleepiness at daytime in moderate to severe OSAHS patients still need further research.