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01-09-2021 | Sleep Apnea | Sleep Breathing Physiology and Disorders • Review

Impact of CPAP on arterial stiffness in patients with obstructive sleep apnea: a meta-analysis of randomized trials

Authors: Sintya T. Chalegre, Ozeas L. Lins-Filho, Thais C. Lustosa, Marcus V. França, Tarcya L. G. Couto, Luciano F. Drager, Geraldo Lorenzi-Filho, Marcio S. Bittencourt, Rodrigo P. Pedrosa

Published in: Sleep and Breathing | Issue 3/2021

Abstract

Purpose

This study aimed to perform a systematic review and meta-analysis of randomized trials investigating the effect of continuous positive airway pressure (CPAP) on non-invasive markers of arterial stiffness in patients with OSA.

Methods

The purpose of the study was to evaluate the effect of CPAP on markers of arterial stiffness (pulse wave velocity (PWV) and augmentation index (Aix)) in patients with OSA. The study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically reviewed MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, and LILACS databases for randomized trials (RT) evaluating the changes in markers of arterial stiffness (pulse wave velocity (PWV) and augmentation index (Aix) comparing CPAP vs. controls in patients with OSA. Reviewer Manager version 5.3 (R Foundation for Statistical Computing, Vienna, Austria) was used to perform meta-analysis. Risk of bias analysis was performed using the Cochrane tool.

Results

Of the 464 studies initially retrieved, 9 relevant studies with 685 participants were included in the analysis. The studies presented moderate risk of bias. CPAP did not significantly reduce Aix (mean difference, − 1.96 (95% confidence interval (CI) − 5.25 to 1.33), p = 0.24), whereas it significantly changed PWV (mean difference, − 0.44 (95% confidence interval (CI) − 0.76 to − 0.12), p = 0.00).

Conclusion

CPAP treatment was effective in improving arterial stiffness by reducing PWV in patients with OSA. Additional randomized trials, however, should be performed to confirm these findings.

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Title: Impact of CPAP on arterial stiffness in patients with obstructive sleep apnea: a meta-analysis of randomized trials
Authors: Sintya T. Chalegre
Ozeas L. Lins-Filho
Thais C. Lustosa
Marcus V. França
Tarcya L. G. Couto
Luciano F. Drager
Geraldo Lorenzi-Filho
Marcio S. Bittencourt
Rodrigo P. Pedrosa
Publication date: 01-09-2021
Publisher: Springer International Publishing
Keyword: Sleep Apnea
Published in: Sleep and Breathing / Issue 3/2021
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-020-02226-7

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