Cannabinoids for obstructive sleep apnea: A systematic review.

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Pharmacotherapy Pub Date : 2024-11-05 DOI:10.1002/phar.4622
Paul M Boylan, Melissa Santibañez, Jennifer Thomas, Erin Weeda, Zachary R Noel, Joshua Caballero
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引用次数: 0

Abstract

Cannabinoids have emerged as a potential treatment for obstructive sleep apnea (OSA). This systematic review aimed to summarize the efficacy and safety of cannabinoids to treat OSA. Databases including Ovid MEDLINE, EMBASE, Scopus, PsycINFO, and International Pharmaceutical Abstracts were searched; experimental and observational studies were eligible for inclusion. One-hundred seventy unique records were screened, and nine studies included: five full-text studies and four published abstracts. The five full-text studies were judged for quality appraisal: two studies deemed at low risk for bias, one study deemed to have some concerns for bias, and two studies deemed to have high risk for bias. Seven of nine total studies were experimental designs and evaluated dronabinol, and the other two studies were observational designs evaluating cannabis. The range of cannabinoid therapy duration spanned from 1 to 6 weeks, and the median duration was 3 weeks. Eight of nine total studies reported statistically significant, positive OSA outcomes due to cannabinoid therapy including reductions in the apnea hypopnea index and improvements in patient-reported daytime sleepiness scales. Between 70% and 80% of study participants reported neuropsychiatric and gastrointestinal adverse events attributable to cannabinoids. The American Academy of Sleep Medicine does not recommend using cannabinoids to treat OSA due to a lack of long-term safety and efficacy data. This systematic review found similar limitations, with the median cannabinoid treatment duration being only 3 weeks. Adequately powered experimental trials over longer time frames are necessary to more completely assess the long-term efficacy and safety of cannabinoids in the treatment of OSA and its effects on common comorbid conditions, such as obesity and cardiovascular disease.

治疗阻塞性睡眠呼吸暂停的大麻素:系统综述。
大麻素已成为阻塞性睡眠呼吸暂停(OSA)的一种潜在治疗方法。本系统综述旨在总结大麻素治疗 OSA 的有效性和安全性。检索的数据库包括 Ovid MEDLINE、EMBASE、Scopus、PsycINFO 和《国际医药文摘》;实验性和观察性研究均可纳入。共筛选出 170 条独特记录,其中包括 9 项研究:5 项全文研究和 4 项发表的摘要。对五篇全文研究进行了质量评估:两篇研究被认为存在低偏倚风险,一篇研究被认为存在一些偏倚问题,两篇研究被认为存在高偏倚风险。在总共九项研究中,七项研究采用实验设计,对屈大麻酚进行评估,另外两项研究采用观察设计,对大麻进行评估。大麻素治疗的持续时间从 1 周到 6 周不等,中位持续时间为 3 周。在总共 9 项研究中,有 8 项研究报告称大麻素治疗对 OSA 有显著的统计学意义,包括降低呼吸暂停低通气指数和改善患者报告的白天嗜睡量表。70%到 80% 的研究参与者报告了可归因于大麻素的神经精神和胃肠道不良事件。由于缺乏长期安全性和有效性数据,美国睡眠医学学会不建议使用大麻素治疗 OSA。本系统综述也发现了类似的局限性,大麻素治疗持续时间的中位数仅为 3 周。为了更全面地评估大麻素治疗 OSA 的长期疗效和安全性及其对肥胖和心血管疾病等常见并发症的影响,有必要在更长的时间框架内进行充分的实验研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pharmacotherapy
Pharmacotherapy 医学-药学
CiteScore
7.80
自引率
2.40%
发文量
93
审稿时长
4-8 weeks
期刊介绍: Pharmacotherapy is devoted to publication of original research articles on all aspects of human pharmacology and review articles on drugs and drug therapy. The Editors and Editorial Board invite original research reports on pharmacokinetic, bioavailability, and drug interaction studies, clinical trials, investigations of specific pharmacological properties of drugs, and related topics.
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