Systematisches Review und Metaanalyse kontrollierter Studien zum nicht erholsamen Schlaf

Die Konsequenzen des nicht erholsamen Schlafes sind vielfältig und haben bedeutende gesundheitliche und ökonomische Auswirkungen. So verursachen Erkrankungen, wie das obstruktive Schlafapnoesyndrom oder auch das Restless-Legs-Syndrom, neben dem Leiden und den Einschränkungen der einzelnen Individuen...

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Bibliographic Details
Main Author: Gerhardy, Hanno Julian
Contributors: Sitter, Helmut (Dr.) (Thesis advisor)
Format: Dissertation
Published: Philipps-Universität Marburg 2010
Operative Medizin
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Table of Contents: Non restorative sleep is a severe illness. The resulting problems have a great impact on the life and health of the patient. In this dissertation two reasons for non restorative sleep such as obstructive sleep apnea (OSA) and restless legs syndrome (RLS) were evaluated. The aim of this dissertation was to find all relevant clinical trials and to compare the results where possible. A literature search with predefined keywords and inclusion and exclusion criteria was performed in PubMed followed by hand search of reference lists. The quality of the trials was independently assessed by two researchers. In cases of disagreement, an additional expert was consulted. For good comparable trials a meta-analysis was performed. This was only feasible for OSA-Trials. 60 therapeutical trials were found for OSA with a total of 3747 patients and 55 for RLS with a total of 4171 patients. 48 OSA-trials were evaluated with the best rating (1b) and 28 of the RLS-trials reached the best rating. The meta-analysis was performed for comparison of the APAP versus the CPAP therapies. For eight endpoints a meta-analysis was calculated with the help of the RevMan software. The result of the meta-analysis was, that the two treatments are identical in their outcome. Because of that the CPAP therapie is still the first choice as it is the better known and tested treatment. For comparison of the CPAP versus the conservative treatment the conducted meta-analysis showed a superior treatment effect with the CPAP therapy. Because of the different end-points and trial-designs it was only possible to perform a systematic review of the RLS-trials. In this review the two treatments of choice were a conservative treatment with dopamine agonists and antiepileptics.