Evaluating pharmacological treatments for excessive daytime sleepiness in obstructive sleep apnea: A comprehensive network meta-analysis and systematic review

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dc.contributor.authorNeshat, Seyed Sina
dc.contributor.authorHeidari, Afshin
dc.contributor.authorHenriquez-Beltran, Mario
dc.contributor.authorPatel, Kripa
dc.contributor.authorColaco, Brendon
dc.contributor.authorArunthari, Vichaya
dc.contributor.authorMateus, Alejandra Yu Lee
dc.contributor.authorCheung, Joseph
dc.contributor.authorLabarca, Gonzalo
dc.date.accessioned2025-01-20T16:16:01Z
dc.date.available2025-01-20T16:16:01Z
dc.date.issued2024
dc.description.abstractObstructive sleep apnea (OSA) is associated with excessive daytime sleepiness (EDS). Pharmacotherapy offers a potential treatment approach for EDS in OSA patients. This systematic review and meta-analysis aimed to assess the efficacy and safety of pharmacological interventions for alleviating EDS in patients with OSA. Following PRISMA guidelines, we included randomized controlled trials investigating pharmacological treatments for EDS in adult OSA until August 2023. We conducted meta-analysis, subgroup, and meta-regression analyses using a random effects model. Finally, a network meta-analysis synthesized direct and indirect evidence, followed by a comprehensive safety analysis. We included 32 articles in the meta-analysis (n = 3357). Pharmacotherapy showed a significant improvement in the Epworth Sleepiness Scale (ESS) score (Mean Difference (MD) -2.73, (95 % Confidence Interval (CI) [-3.25, -2.20], p < 0.01) and Maintenance of Wakefulness Test (MWT) score (MD 6.00 (95 % CI [2.66, 9.33] p < 0.01). Solriamfetol, followed by Pitolisant and modafinil, exhibited the greatest ESS reduction, while Danavorexton, followed by Solriamfetol and MK-7288, had the strongest impact on MWT. MK-7288 had the most total adverse events (AEs), followed by Danavorexton and armodafinil. Pharmacological Interventions significantly alleviate EDS in OSA patients but with heterogeneity across medications. Treatment decisions should involve a personalized assessment of patient factors and desired outcomes.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.smrv.2024.101934
dc.identifier.eissn1532-2955
dc.identifier.issn1087-0792
dc.identifier.urihttps://doi.org/10.1016/j.smrv.2024.101934
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90525
dc.identifier.wosidWOS:001244529900001
dc.language.isoen
dc.revistaSleep medicine reviews
dc.rightsacceso restringido
dc.subjectObstructive sleep apnea
dc.subjectExcessive daytime sleepiness
dc.subjectMaintenance of wakefulness test
dc.subjectAdverse events
dc.subjectSleep
dc.subjectApnea
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleEvaluating pharmacological treatments for excessive daytime sleepiness in obstructive sleep apnea: A comprehensive network meta-analysis and systematic review
dc.typeartículo
dc.volumen76
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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