Data_Sheet_1_Efficacy of hyperbaric oxygen therapy as an adjunct therapy in the treatment of sleep disorders among patients with Parkinson’s disease: a meta-analysis.docx

ObjectiveTo systematically evaluate the efficacy of hyperbaric oxygen therapy (HBOT) as an adjunct therapy for treating sleep disorders in patients with Parkinson’s disease (PD).
MethodsWe conducted comprehensive searches in eight databases from inception through September 2023, including PubMed, Cochrane Library, Embase, Web of Science, SinoMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Periodical Database (VIP), and Wanfang Database. The objective was to identify randomized controlled trials (RCTs) evaluating HBOT’s effectiveness in alleviating sleep disorder symptoms in PD patients as an adjunct therapy. Literature screening and data extraction were independently executed by the authors. Meta-analyses were performed using Review Manager 5.3 software, and publication bias and sensitivity analyses were assessed using Stata 17.0 software.
ResultsSeven RCTs involving 461 participants were included. The findings revealed that the addition of HBOT significantly enhanced sleep efficiency (MD = 15.26, 95% CI [10.89, 19.63], p < 0.00001), increased time in bed (MD = 69.65, 95% CI [43.01, 96.30], p < 0.00001), total sleep time (MD = 75.87, 95% CI [25.42, 126.31], p = 0.003), slow-wave sleep (SWS) time (MD = 6.14, 95% CI [3.95, 8.34], p < 0.00001), and rapid eye movement sleep (REM) time (MD = 4.07, 95% CI [2.05, 6.08], p < 0.0001), and reduced awakening frequency (MD = −11.55, 95% CI [−15.42, −7.68], p < 0.00001) and sleep latency (MD = −6.60, 95% CI [−9.43, −3.89], p < 0.00001). Additionally, significant improvements were observed in the Pittsburgh Sleep Quality Index (PSQI) (MD = −2.52, 95% CI [−2.85, −2.18], p < 0.00001), Epworth Sleepiness Scale (ESS) (MD = −2.90, 95% CI [−3.34, −2.47], p < 0.00001), Unified Parkinson’s Disease Rating Scale Part III (UPDRS III) (MD = −1.32, 95% CI [−2.16, −0.47], p = 0.002), and Hoehn and Yahr grading (H-Y grading) (MD = −0.15, 95% CI [−0.28, −0.01], p = 0.03).
ConclusionThe current meta-analysis supports the efficacy of HBOT as an adjunct therapy in managing sleep disorders in PD patients. It is recommended for PD patients experiencing sleep disturbances.
Systematic review registration:https://www.crd.york.ac.uk/, identifier: CRD42023462201.

目的：系统评价高压氧治疗（hyperbaric oxygen therapy, HBOT）作为辅助疗法治疗帕金森病（Parkinson’s disease, PD）患者睡眠障碍的临床疗效。
方法：本研究于2023年9月前系统性检索了8个数据库自建库以来的文献，包括PubMed、Cochrane Library、Embase、Web of Science、中国生物医学文献数据库（SinoMed）、中国知网（China National Knowledge Infrastructure, CNKI）、中文科技期刊数据库（VIP）及万方数据库。旨在识别以辅助疗法形式评估HBOT缓解PD患者睡眠障碍症状有效性的随机对照试验（randomized controlled trial, RCT）。文献筛选与数据提取工作由研究人员独立完成。采用Review Manager 5.3软件进行Meta分析，使用Stata 17.0软件评估发表偏倚与敏感性分析。
结果：本研究共纳入7项RCT，涉及461名受试者。结果显示，在常规治疗基础上加用HBOT可显著改善睡眠效率（均数差MD=15.26，95%置信区间CI[10.89, 19.63]，p<0.00001），延长卧床时间（MD=69.65，95%CI[43.01, 96.30]，p<0.00001）、总睡眠时间（MD=75.87，95%CI[25.42, 126.31]，p=0.003）、慢波睡眠（slow-wave sleep, SWS）时长（MD=6.14，95%CI[3.95, 8.34]，p<0.00001）及快速眼动睡眠（rapid eye movement sleep, REM）时长（MD=4.07，95%CI[2.05, 6.08]，p<0.0001）；同时可降低觉醒频率（MD=-11.55，95%CI[-15.42, -7.68]，p<0.00001）与睡眠潜伏期（MD=-6.60，95%CI[-9.43, -3.89]，p<0.00001）。此外，HBOT辅助治疗还可显著改善匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index, PSQI）（MD=-2.52，95%CI[-2.85, -2.18]，p<0.00001）、Epworth嗜睡量表（Epworth Sleepiness Scale, ESS）评分（MD=-2.90，95%CI[-3.34, -2.47]，p<0.00001）、帕金森病统一评分量表第三部分（Unified Parkinson’s Disease Rating Scale Part III, UPDRS III）得分（MD=-1.32，95%CI[-2.16, -0.47]，p=0.002）及Hoehn-Yahr分级（H-Y分级）（MD=-0.15，95%CI[-0.28, -0.01]，p=0.03）。
结论：本项Meta分析证实，HBOT作为辅助疗法可有效改善PD患者的睡眠障碍，推荐用于伴睡眠紊乱的PD患者。
系统评价注册：https://www.crd.york.ac.uk/，注册号：CRD42023462201。