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Review
. 2024 Mar 20;33(171):230173.
doi: 10.1183/16000617.0173-2023. Print 2024 Jan 31.

Nocturnal oxygen therapy in obstructive sleep apnoea: a systematic review and meta-analysis

Su Latt Phyu  1   2 , Selin Ercan  3   2 , Eli Harriss  4 , Christopher Turnbull  5   6
Affiliations
Review

Nocturnal oxygen therapy in obstructive sleep apnoea: a systematic review and meta-analysis

Su Latt Phyu et al. Eur Respir Rev. .

Abstract

Obstructive sleep apnoea is characterised by recurrent reduction of airflow during sleep leading to intermittent hypoxia. Continuous positive airway pressure is the first-line treatment but is limited by poor adherence. Nocturnal oxygen therapy may be an alternative treatment for obstructive sleep apnoea but its effects remain unclear. This meta-analysis evaluates the effects of nocturnal oxygen therapy on both obstructive sleep apnoea severity and blood pressure.A literature search was performed based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Peer-reviewed, randomised studies that compared the effect of nocturnal oxygen therapy to sham in obstructive sleep apnoea patients were included. The main outcomes were the apnoea-hypopnoea index and systolic and diastolic blood pressure.The search strategy yielded 1295 citations. Nine studies with 502 participants were included. When nocturnal oxygen therapy was compared to sham/air, it significantly reduced the apnoea-hypopnoea index (mean difference (MD) -15.17 events·h-1, 95% CI -19.95- -10.38 events·h-1, p<0.00001). Nocturnal oxygen therapy had no significant effect on blood pressure at follow-up without adjustment for baseline values, but did, where available, significantly attenuate the change in blood pressure from baseline to follow-up for both systolic blood pressure (MD -2.79 mmHg, 95% CI -5.45- -0.14 mmHg, p=0.040) and diastolic blood pressure (MD -2.20 mmHg, 95% CI -3.83- -0.57 mmHg, p=0.008).Nocturnal oxygen therapy reduced the apnoea-hypopnoea index severity and the change in (but not absolute) systolic and diastolic blood pressure, compared to sham. This suggests that nocturnal oxygen therapy may be a treatment option for obstructive sleep apnoea. Further studies with longer-term follow-up and standardised measurements are needed.

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Conflict of interest statement

Conflict of interest: C. Turnbull reports honoraria from Stowood Scientific, outside the scope of this submission. There are no other relevant competing interests.

Figures

FIGURE 1
FIGURE 1
Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow chart of the literature search.
FIGURE 2
FIGURE 2
Forest plot of apnoea–hypopnoea index (AHI) a) with desaturation and b) without desaturation. NOT: nocturnal oxygen therapy; IV: inverse variance.
FIGURE 3
FIGURE 3
Forest plot of oxygen desaturation index. NOT: nocturnal oxygen therapy; IV: inverse variance.
FIGURE 4
FIGURE 4
Forest plot of follow-up a) systolic blood pressure (SBP) and b) diastolic blood pressure (DBP). NOT: nocturnal oxygen therapy; IV: inverse variance.
FIGURE 5
FIGURE 5
Forest plot of change in a) systolic blood pressure (SBP) and b) diastolic blood pressure (DBP). NOT: nocturnal oxygen therapy; IV: inverse variance.
See this image and copyright information in PMC

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