Osahs Patients With CPAP Complained of Multiple Side Effects: A Meta-analysis of Randomized Trials

Abstract

PURPOSE:CPAP (Continuous Positive Airway Pressure) is the "gold standard" treatment for OSAHS (Obstructive Sleep Apnea Hypopnea Syndrome). However, its compliance is only 30% to 70%. Much of the compliance reduction depends on its side effects. This study aimed to perform a meta-analysis of all randomized trials that statistically analyzed the side effects of CPAP.METHODS:The Cochrane, Embase, and Pubmed were searched for relevant studies from inception until September 2019 with the following terms: "OSAHS" and "CPAP" and "side effects". Two reviewers independently extracted data. Meta-analyses on adverse outcomes were calculated with a frequentist approach. Summary sensitivity analysis, risk of bias, and 95%CIs were also obtained. All statistical analyses were performed with R package metaRESULTS:All side effects investigated can be broadly classified into four categories including respiratory tract discomfort, discomfort of the mask, psychological pressure and specific gastrointestinal symptoms. Overall, the random effects meta-analysis revealed that dry symptoms (0.23;95% CI, 0.16-0.32), gas leakage (0.17;95% CI, 0.10-0.27) and sleep disorders (0.14;95% CI, 0.11-0.18) were associated with a higher incidence. Another intergroup analysis showed statistically significant differences in the incidence of dryness and sleep disturbance (0.23;95% CI, 0.16-0.32 vs. 0.14;95% CI, 0.11-0.18, respectively; P =.04)CONCLUSION:Side effects of CPAP are multifaceted and occur in combination with high probability. The impact of specific side effects on compliance needs to be further investigated in clinical data. Meanwhile, medical workers need to consider further the impact of side effects and timely adjust relevant treatment plans or nursing service in the clinic.