Diagnostic accuracy of screening questionnaires for obstructive sleep apnoea in adults in different clinical cohorts: a systematic review and meta-analysis

AbstractObjectivesObstructive sleep apnoea is a common chronic sleep disorder characterised by collapse of the upper airway during sleep. The nasal airway forms a significant part of the upper airway and any obstruction is thought to have an impact on obstructive sleep apnoea. A systematic review was performed to determine the role of rhinological surgical interventions in the management of obstructive sleep apnoea.MethodsA systematic review of current literature was undertaken; studies were included if they involved comparison of a non-surgical and/or non-rhinological surgical intervention with a rhinological surgical intervention for treatment of obstructive sleep apnoea.ResultsSixteen studies met the selection criteria. The pooled data suggest that there are reductions in the apnoea/hypopnea index and respiratory disturbance index following nasal surgery. However, the current body of studies is too heterogeneous for statistically significant meta-analysis to be conducted.ConclusionNasal surgery may have limited benefit for a subset of patients based on current evidence.

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Impact of surgical maxillomandibular advancement upon pharyngeal airway volume and the apnoea–hypopnoea index in the treatment of obstructive sleep apnoea: systematic review and meta-analysis

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2019-000402 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000402 ◽

Cited By ~ 3

Author(s):

Maria Giralt-Hernando ◽

Adaia Valls-Ontañón ◽

Raquel Guijarro-Martínez ◽

Jorge Masià-Gridilla ◽

Federico Hernández-Alfaro

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnoea ◽

Meta Analysis ◽

Sleep Apnoea ◽

Eligibility Criteria ◽

Pharyngeal Airway ◽

Maxillomandibular Advancement ◽

Subsequent Decrease ◽

Obstructive Sleep

BackgroundA systematic review was carried out on the effect of surgical maxillomandibular advancement (MMA) on pharyngeal airway (PA) dimensions and the apnoea–hypopnoea index (AHI) in the treatment of obstructive sleep apnoea (OSA), with the aim of determining whether increased PA in the context of MMA is the main factor conditioning the subsequent decrease in AHI.MethodsA search was made of the PubMed, Embase, Google Scholar and Cochrane databases. A total of 496 studies were identified. The inclusion criteria were a diagnosis of moderate to severe OSA, MMA success evaluated by polysomnography, reporting of the magnitude of MMA achieved, PA increase and a minimum follow-up of 6 months.ResultsFollowing application of the eligibility criteria, eight articles were included. Metaregression analysis showed MMA to significantly increase both pharyngeal airway volume (PAV) (mean 7.35 cm3 (range 5.35–9.34)) and pharyngeal airway space (mean 4.75 mm (range 3.15–6.35)) and ensure a final AHI score below the threshold of 20 (mean 12.9 events/hour).ConclusionsAlthough subgroup analysis showed MMA to be effective in treating OSA, more randomised trials are needed to individualise the required magnitude and direction of surgical movements in each patient, and to standardise the measurements of linear and nonlinear PAV parameters.

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Management of paediatric obstructive sleep apnoea: A systematic review and network meta‐analysis

International Journal of Paediatric Dentistry ◽

10.1111/ipd.12593 ◽

2019 ◽

Vol 30 (2) ◽

pp. 156-170 ◽

Cited By ~ 1

Author(s):

Shih‐Ying Lin ◽

Yu‐Xuan Su ◽

Yi‐Cheng Wu ◽

Jenny Zwei‐Chieng Chang ◽

Yu‐Kang Tu

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnoea ◽

Meta Analysis ◽

Sleep Apnoea ◽

Obstructive Sleep

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Association of obstructive sleep apnoea with the presence and severity of non-alcoholic fatty liver disease. A systematic review and meta-analysis

Obesity Reviews ◽

10.1111/obr.12020 ◽

2013 ◽

Vol 14 (5) ◽

pp. 417-431 ◽

Cited By ~ 119

Author(s):

G. Musso ◽

M. Cassader ◽

C. Olivetti ◽

F. Rosina ◽

G. Carbone ◽

...

Keyword(s):

Systematic Review ◽

Liver Disease ◽

Fatty Liver ◽

Obstructive Sleep Apnoea ◽

Fatty Liver Disease ◽

Meta Analysis ◽

Sleep Apnoea ◽

Alcoholic Fatty Liver ◽

Obstructive Sleep ◽

Alcoholic Fatty Liver Disease

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Effect of obstructive sleep apnoea on diabetic retinopathy and maculopathy: a systematic review and meta-analysis

Diabetic Medicine ◽

10.1111/dme.12817 ◽

2015 ◽

Vol 33 (2) ◽

pp. 158-168 ◽

Cited By ~ 30

Author(s):

W. B. Leong ◽

F. Jadhakhan ◽

S. Taheri ◽

Y. F. Chen ◽

P. Adab ◽

...

Keyword(s):

Systematic Review ◽

Diabetic Retinopathy ◽

Obstructive Sleep Apnoea ◽

Meta Analysis ◽

Sleep Apnoea ◽

Obstructive Sleep

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Drug-induced sleep endoscopy compared with systematic adenotonsillectomy in the management of obstructive sleep apnoea in children: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2018-028242 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028242 ◽

Cited By ~ 1

Author(s):

Anne-Sophie Prévost ◽

Mathieu Hylands ◽

Mireille Gervais ◽

Jean-Paul Praud ◽

Marie-Claude Battista ◽

...

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnoea ◽

Data Extraction ◽

Meta Analysis ◽

Sleep Apnoea ◽

Published Data ◽

Sleep Endoscopy ◽

Drug Induced ◽

Drug Induced Sleep Endoscopy ◽

Obstructive Sleep

IntroductionObstructive sleep apnoea affects up to 6% of children worldwide. Although current guidelines recommend systematic tonsillectomy and adenoidectomy, many children do not benefit from these interventions. Drug-induced sleep endoscopy (DISE) allows the dynamic evaluation of patients’ airways to identify the specific anatomic sites of obstruction. This intervention can potentially guide subsequent invasive procedures to optimise outcomes and minimise the number of children exposed to unnecessary operations.Methods and analysisWe will identify randomised controlled trials and controlled observational studies comparing DISE-directed interventions to systematic tonsillectomy and adenoidectomy in paediatric populations. We will search MEDLINE, EMBASE, CINAHL, CENTRAL as well as clinical trial registries and conference proceedings (initial electronic search date 9 October 2018). Screening, data extraction and risk of bias assessments will be performed in duplicate by independent reviewers. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to assess the overall quality of evidence and present our results.Ethics and disseminationEthics approval is not required for this systematic review of published data. This review will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will present our findings at otorhinolaryngology conferences and publish a report in a peer-reviewed journal.PROSPERO registration numberCRD42018085370.

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Experiences of Using Positive Airway Pressure for Treatment of Obstructive Sleep Apnoea: A Systematic Review and Thematic Synthesis

SLEEP ◽

10.1093/sleep/zsab135 ◽

2021 ◽

Author(s):

Amy Brown ◽

Steven Jones ◽

Guillermo Perez-Algorta

Keyword(s):

Systematic Review ◽

Effective Treatment ◽

Obstructive Sleep Apnoea ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Meta Analysis ◽

Service Level ◽

Sleep Apnoea ◽

Thematic Synthesis ◽

Obstructive Sleep

Abstract Study objectives Sub-optimal use of positive airway pressure (PAP) to treat obstructive sleep apnoea (OSA) continues to be a major challenge to effective treatment. Meanwhile, the individual and societal impacts of untreated OSA make effective treatment a priority. Although extensive research has been conducted into factors that impact PAP use, it is estimated that at least half of users do not use it as prescribed. However, the voice of users is notably minimal in the literature. A systematic review and qualitative metasynthesis of PAP user experience was conducted to contribute to understandings of how PAP is experienced and to inform how usage could be improved. Methods PsycINFO, MEDLINE, CINAHL and EMBASE databases were systematically searched. Primary research findings of adult experiences using PAP that had been inductively analysed were included. Papers were critically appraised using the CASP qualitative checklist to generate a “hierarchy of evidence”. Thematic synthesis was then conducted to generate analytical themes. Results were presented in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Results 25 papers reporting on over 398 people’s experiences were analysed to generate 4 themes: Journey to PAP, Discomfort from and around PAP, Adapting to and using PAP, and Benefits from PAP. Author reflexivity and vulnerability to bias is acknowledged. Conclusions The findings highlight the applicability of a biopsychosocial understanding to PAP use. This metasynthesis gave voice to user experiences, revealing barriers to PAP use at a healthcare service level across the world, and suggests ways services can address these barriers.

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