The prevalence of obstructive sleep apnea-hypopnea syndrome in patients with cystic fibrosis: An updated systematic review and meta-analysismeta-analysis

BACKGROUND: This research aimed to evaluate the prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) in individuals with cystic fibrosis (CF) and to examine its relationship with sleep monitoring parameters and pulmonary function. METHODS: Five databases (EMBASE, PubMed, Web of Science, CNKI, and Cochrane Library) were searched for publications on the prevalence of OSAHS in CF. Two independent researchers assessed study quality using the Joanna Briggs Institute tool. Weighted mean differences were calculated for continuous variables, and the model choice (random vs fixed effects) was determined by whether I2 exceeded 50%. RESULTS: Fourteen studies were included: 11 in the prevalence meta-analysis and 13 in the mean apnea-hypopnea index (AHI) analysis. Six studies compared sleep and pulmonary parameters between CF patients with and without OSAHS. The pooled prevalence of OSAHS in CF was 48% (I2 = 96.5%), slightly higher in pediatric than adult patients. The mean AHI was 3.47 in pediatric patients with CF and 6.19 in adult individuals with CF. Compared to OSAHS-negative patients, OSAHS-positive patients exhibited higher AHI and arousal index, lower mean and minimum oxygen saturation, and worse pulmonary function. CONCLUSION: There is a significant prevalence of OSAHS among patients with CF, notably within the pediatric demographic. Patients with CF generally present with elevated AHI values and poorer pulmonary function in those with concurrent OSAHS. The findings advocate for earlier polysomnography screening in patients with CF to facilitate timely intervention.