Lifestyle modification for obstructive sleep apnoea

 

Abstract

Background

Obstructive sleep apnoeas are due to transient closure of the upper airway during sleep and merge into hypopnoeas in which the airway narrows, but some airflow continues. They are due to the forces compressing the airway overcoming those which stabilise its patency. The commonest association is obesity in which fatty tissue is deposited around the airway. Exercise has been recommended as a method of losing weight, but other techniques which achieve this are also thought to improve symptoms due to sleep apnoeas. Sleep hygiene may alter the sleep structure and the control of the upper airway during sleep and thus promote its patency.

Objectives

The objectives of this review are to determine whether weight loss, sleep hygiene and exercise are effective in the treatment of obstructive sleep apnoeas.

Search methods

The Cochrane Airways Group Specialised Register, CENTRAL, MEDLINE, EMBASE, CINAHL and reference lists of review articles have been searched. The date of the last search was April 2009.

Selection criteria

Randomised, single or double blind placebo controlled, either parallel group or crossover design studies of any of these interventions were to have been included.

Data collection and analysis

No completed trials have been identified.

Main results

No randomised trial data were available for analysis. An update search has identified a study presented in abstract form only. The findings from one additional ongoing study are awaited.

Authors' conclusions

There is a need for randomised controlled trials of these commonly used treatments in obstructive sleep apnoeas. These should identify which sub groups of patients with sleep apnoeas benefit most from each type of treatment and they should have clear and standardised outcome measures.

 

Plain language summary

Lifestyle modification strategies for managing obstructive sleep apnoea

Obstructive sleep apnoea happens when breathing is either stopped or reduced during sleep because of a narrowing or blockage of the upper airway (passage to the lungs). It causes loud snoring and occasional apnoea (stopping breathing). It can lead to daytime sleepiness and may cause, hypertension, stroke and road accidents. Lifestyle modification, especially weight loss, sleep hygiene and exercise, are often recommended. These could help by relieving pressure on the upper airway, and increasing muscle tone in the airway. However, the review found no trials to assess the effects of these strategies, and more research is needed.

 

摘要

背景

生活型態調整對於阻塞性睡眠呼吸中止者的影響

阻塞性睡眠呼吸中止是指，睡眠時上呼吸道暫時關閉，並且因為呼吸道狹窄僅有氣流通過，而合併有呼吸過少的情況，這是由於壓迫呼吸道的力量超過穩定維持其通暢的力量所致。 最常見與此症相關的原因是肥胖，因為肥胖者的脂肪組織堆積在呼吸道四周。通常建議利用運動來減重，但其他用來減重的方式或技巧也可改善睡眠呼吸中止的症狀。睡眠保健法可改變睡眠結構並於睡眠時控制上呼吸道，於是可使其維持通暢

目標

本篇文獻回顧的主要目的在確認減重、睡眠保健法及運動等是否能有效治療阻塞性睡眠呼吸中止

搜尋策略

我們搜尋了The Cochrane Airways Group Specialised Register, CENTRAL, MEDLINE, EMBASE, CINAHL，及文獻的參考資料。最後搜尋日期為2007年4月

選擇標準

無論是並行的或交叉設計的隨機單盲或雙盲安慰劑對照試驗皆被納入

資料收集與分析

沒有找到完整的研究

主要結論

沒有隨機試驗的數據可用來分析，最新的搜尋只找到一個以摘要形式發表的研究，另一個正在進行的研究，則尚待其結果研究

作者結論

針對睡眠呼吸中止常見治療方式的隨機對照試驗有其必要性。需要確認何種形式的治療最有益於哪一種亞型的睡眠呼吸中止病患，並應有清楚且標準化的方式來評量研究結果

翻譯人

本摘要由國泰綜合醫院劉怡敏翻譯

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

阻塞性睡眠呼吸中止係指睡眠時呼吸中斷或減少，可能是因為睡眠時上呼吸道(到達肺部的路徑)狹窄或阻塞所造成。通常會產生音量大的打鼾聲，並偶爾呼吸暫停。病患會有白天嗜睡的症狀，且會併發高血壓、中風，甚至容易因而發生車禍。 對於此類病患，通常建議調整生活型態以改善症狀，包括減重、睡眠保健法、以及運動，這些方法可減輕上呼吸道的壓力，並增加呼吸道的肌肉張力。 然而，進行文獻回顧並沒有找到針對這些治療方式及其效果的研究，所以需要更多的研究