Abstract：
Studies show that patients with obstructive sleep apnea (OSA) are more likely than the general population to have psychological disorders such as depression. However, it is less clear how OSA treatment affects this association. This meta-analysis aimed to assess whether or not continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) reduce depression symptoms in patients with OSA.
We searched Pubmed, Embase, Web of Science, and Cochrane Library from creating the databases until November 2022. Our analysis included RCTs that examined CPAP and MAD treatment effectiveness for depression in patients with OSA.
We identified 17 CPAP studies comprising 1,931 patients for inclusion in the meta-analysis. The results of the meta-analysis using a fixed effects model found that CPAP improved depressed mood in patients with OSA relative to controls (SMD = 0.27;95% CI:0.18,0.36), with small heterogeneity among trials (I2 = 8.1% < 50%, P = 0.359). We performed subgroup analyses on three factors: the length of trial follow-up, patient adherence data, and depression assessment scales. The meta-analysis also identified six MAD studies involving 315 patients. According to this analysis, there was no heterogeneity between studies (I2 = 0%, P = 0.748). MADs did not significantly improve depression symptoms compared to controls, indicating a combined effect of SMD = 0.07 (95% CI: - 0.15,0.29), P > 0.05.
The present findings confirm that CPAP may improve depressive symptoms in patients with OSA. However, the review results suggest that MADs have no significant effect on depressive symptoms in patients with OSA, a finding that is different from the results of previous meta-analyses.
We searched Pubmed, Embase, Web of Science, and Cochrane Library from creating the databases until November 2022. Our analysis included RCTs that examined CPAP and MAD treatment effectiveness for depression in patients with OSA.
We identified 17 CPAP studies comprising 1,931 patients for inclusion in the meta-analysis. The results of the meta-analysis using a fixed effects model found that CPAP improved depressed mood in patients with OSA relative to controls (SMD = 0.27;95% CI:0.18,0.36), with small heterogeneity among trials (I2 = 8.1% < 50%, P = 0.359). We performed subgroup analyses on three factors: the length of trial follow-up, patient adherence data, and depression assessment scales. The meta-analysis also identified six MAD studies involving 315 patients. According to this analysis, there was no heterogeneity between studies (I2 = 0%, P = 0.748). MADs did not significantly improve depression symptoms compared to controls, indicating a combined effect of SMD = 0.07 (95% CI: - 0.15,0.29), P > 0.05.
The present findings confirm that CPAP may improve depressive symptoms in patients with OSA. However, the review results suggest that MADs have no significant effect on depressive symptoms in patients with OSA, a finding that is different from the results of previous meta-analyses.
摘要：
目的：研究表明，阻塞性睡眠呼吸暂停（OSA）患者比普通人群更有可能患有抑郁症等心理障碍。然而,目前尚不清楚OSA治疗如何影响这种关联.这项荟萃分析旨在评估持续气道正压通气（CPAP）和下颌前移装置（MAD）是否可以减轻OSA患者的抑郁症状。
方法：我们搜索了Pubmed，Embase,WebofScience,和Cochrane图书馆从创建数据库到2022年11月。我们的分析包括检查CPAP和MAD治疗OSA患者抑郁症有效性的RCT。
结果：我们确定了17项包含1,931名患者的CPAP研究纳入荟萃分析。使用固定效应模型的荟萃分析结果发现，相对于对照组，CPAP改善了OSA患者的抑郁情绪（SMD=0.27；95％CI：0.18,0.36），试验间异质性小(I2=8.1%<50%，P=0.359)。我们对三个因素进行了亚组分析：试验随访时间，患者依从性数据，和抑郁评估量表。荟萃分析还确定了6项MAD研究，涉及315名患者。根据这一分析,研究之间没有异质性(I2=0%，P=0.748）。与对照组相比，MAD并未显着改善抑郁症状，表明SMD=0.07的综合效应(95%CI：-0.15,0.29)，P>0.05。
结论：本研究结果证实CPAP可以改善OSA患者的抑郁症状。然而,回顾结果表明，MAD对OSA患者的抑郁症状没有显着影响，这一发现与以前的荟萃分析结果不同。
方法：我们搜索了Pubmed，Embase,WebofScience,和Cochrane图书馆从创建数据库到2022年11月。我们的分析包括检查CPAP和MAD治疗OSA患者抑郁症有效性的RCT。
结果：我们确定了17项包含1,931名患者的CPAP研究纳入荟萃分析。使用固定效应模型的荟萃分析结果发现，相对于对照组，CPAP改善了OSA患者的抑郁情绪（SMD=0.27；95％CI：0.18,0.36），试验间异质性小(I2=8.1%<50%，P=0.359)。我们对三个因素进行了亚组分析：试验随访时间，患者依从性数据，和抑郁评估量表。荟萃分析还确定了6项MAD研究，涉及315名患者。根据这一分析,研究之间没有异质性(I2=0%，P=0.748）。与对照组相比，MAD并未显着改善抑郁症状，表明SMD=0.07的综合效应(95%CI：-0.15,0.29)，P>0.05。
结论：本研究结果证实CPAP可以改善OSA患者的抑郁症状。然而,回顾结果表明，MAD对OSA患者的抑郁症状没有显着影响，这一发现与以前的荟萃分析结果不同。
