Impact of the COVID-19 pandemic on adherence to positive airway pressure treatment in patients with obstructive sleep apnea: systematic review and meta-analysis
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Media type:
E-Article
Title:
Impact of the COVID-19 pandemic on adherence to positive airway pressure treatment in patients with obstructive sleep apnea: systematic review and meta-analysis
Contributor:
Jo, Soomin;
Cho, Jaeyoung
Published:
SAGE Publications, 2023
Published in:
Therapeutic Advances in Respiratory Disease, 17 (2023)
Description:
<jats:sec><jats:title>Background:</jats:title><jats:p> The adverse effects of the COVID-19 pandemic on sleep have been well studied. However, whether the COVID-19 pandemic impacted positive airway pressure (PAP) adherence in patients with obstructive sleep apnea (OSA) remains unclear. </jats:p></jats:sec><jats:sec><jats:title>Objectives:</jats:title><jats:p> To evaluate the impact of the COVID-19 pandemic on adherence to PAP therapy in patients with OSA. </jats:p></jats:sec><jats:sec><jats:title>Design:</jats:title><jats:p> A retrospective cohort study, systematic review, and meta-analysis. </jats:p></jats:sec><jats:sec><jats:title>Data sources and methods:</jats:title><jats:p> The retrospective study included adults with OSA who received PAP prescriptions within the year before and the year after the start date of COVID-19 social distancing (22 March 2020) in South Korea. The threshold of clinical significance for PAP adherence was defined as 0.5 h/day. We also searched for relevant studies published up to 15 January 2023 using the MEDLINE and Embase databases. We performed a random-effects meta-analysis of our findings with the identified studies regarding the standardized mean change (SMC) with a 95% CI of PAP adherence. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> Our study included a total of 306 patients (mean age, 59.7 years; men, 73.5%). The average daily PAP usage was 5.10 ± 1.63 h before the COVID-19 pandemic and 4.79 ± 1.96 h during the pandemic (mean difference, −0.31 h/day; 95% CI, −0.46 to −0.15 h/day; p < 0.001 using paired t-test). After identifying 10 observational before-and-after studies through a systematic review, we conducted a meta-analysis that included our original data and showed that adherence to PAP treatment was not different before and during the COVID-19 pandemic (SMC, 0.01; 95% CI, −0.18 to 0.19; p = 0.952). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Although the COVID-19 pandemic had a statistically negative impact on adherence to PAP treatment in South Korea, the effect was not clinically relevant in patients with OSA. According to our meta-analysis, adherence to PAP treatment was not different before and during the COVID-19 pandemic in patients with OSA. </jats:p></jats:sec><jats:sec><jats:title>Trial registration:</jats:title><jats:p> PROSPERO database; No.: CRD42023414268; URL: https://www.crd.york.ac.uk/PROSPERO . </jats:p></jats:sec>