Srivali Narat, Thongprayoon Charat, Cheungpasitporn Wisit
Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, Durham, NC, USA.
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Sleep Breath. 2024 Aug;28(4):1617-1624. doi: 10.1007/s11325-024-03054-9. Epub 2024 May 8.
Interstitial lung disease (ILD) often coexists with obstructive sleep apnea (OSA), contributing to increased morbidity and mortality. However, the effectiveness of continuous positive airway pressure (CPAP) therapy in this population remains unclear. We conducted a systematic review to evaluate CPAP therapy's impact on clinical outcomes in patients with ILD and comorbid OSA.
Following PRISMA guidelines, we systematically searched multiple databases for studies assessing CPAP therapy's effects on ILD exacerbation, hospitalization, quality of life, and mortality in ILD-OSA patients. Studies were selected based on predefined inclusion criteria, and their quality was assessed using the Newcastle-Ottawa quality scale.
Among 485 articles screened, 82 underwent full review, with four observational studies meeting inclusion criteria. CPAP therapy demonstrated potential benefits in improving quality of life and reducing ILD exacerbations in ILD-OSA patients. However, its impact on mortality was inconclusive due to variability in study definitions and methodology.
CPAP therapy may improve outcomes in ILD-OSA patients, particularly in terms of quality of life and ILD exacerbations. Nonetheless, further research with standardized definitions and rigorous methodology is needed to confirm its efficacy, particularly regarding mortality outcome.
间质性肺疾病(ILD)常与阻塞性睡眠呼吸暂停(OSA)共存,导致发病率和死亡率增加。然而,持续气道正压通气(CPAP)治疗在该人群中的有效性仍不明确。我们进行了一项系统评价,以评估CPAP治疗对ILD合并OSA患者临床结局的影响。
遵循PRISMA指南,我们系统检索了多个数据库,以查找评估CPAP治疗对ILD-OSA患者ILD加重、住院、生活质量和死亡率影响的研究。根据预先定义的纳入标准选择研究,并使用纽卡斯尔-渥太华质量量表评估其质量。
在筛选的485篇文章中,82篇进行了全面审查,4项观察性研究符合纳入标准。CPAP治疗在改善ILD-OSA患者生活质量和减少ILD加重方面显示出潜在益处。然而,由于研究定义和方法的差异,其对死亡率的影响尚无定论。
CPAP治疗可能改善ILD-OSA患者的结局,特别是在生活质量和ILD加重方面。尽管如此,仍需要采用标准化定义和严格方法进行进一步研究,以证实其疗效,特别是关于死亡率结局。