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Effect of compression stockings on overnight rostral fluid shift and obstructive sleep apnea: A meta-analysis
Authors:Wei-Chih Liao  Li-Jen Hsin  Hsueh-Yu Li  Ming-Shao Tsai  Yao-Te Tsai  Chung-Chieh Yu  Yi-Chan Lee
Affiliation:1. Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan;2. Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan;3. Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan;4. Division of Pulmonary, Critical Care, and Sleep Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan;5. College of Medicine, Chang Gung University, Taoyuan, Taiwan;1. Hadassah Medical School, Hebrew University, Jerusalem, Israel;2. Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel;3. Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel;1. Neuro-otology, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia;2. Pediatric ENT, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia;3. Division of Otolaryngology, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Carrera 7 40-62, Desk 712, Bogotá, Colombia;4. Pontificia Universidad Javeriana, Bogotá, Colombia;1. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;2. Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;3. Department of Otolaryngology and Head and Neck Surgery, Sanraku Hospital, 2-5 Kandasurugadai, Chiyoda-ku, Tokyo 101-8326, Japan;4. Department of Health Policy and Informatics, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan;1. Fudan University, Shanghai, China;2. Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai 200031, China;3. Shanghai Auditory Medical Center, Shanghai, China;4. Key laboratory of Hearing Science, Ministry of Health, Shanghai, China;5. Department of Economics, London School of Economics and Political Science, London, United Kingdom;6. Department of Power Mechanical Engineering, National Formosa University, Yunlin, Taiwan;7. Numerical and Scientific Computing Laboratory, National Formosa University, Yunlin, Taiwan
Abstract:ObjectiveThe overnight rostral fluid shift from the lower limbs is one of the causes of obstructive sleep apnea (OSA). Compression stockings (CS) prevent lower limb fluid retention and have been reported to decrease nighttime fluid shift. The aim of this study is to evaluate the effect of CS on fluid shift and the severity of OSA.MethodsA systematic literature search was performed in the PubMed, EMBASE and Cochrane Library databases. The data were analyzed using Comprehensive Meta-Analysis software (Version 3; Biostat, Englewood, NJ). Studies evaluating the effect of CS on the overnight fluid shift and OSA severity were included in the analysis.ResultsA total of 4 studies were included in this meta-analysis. The pooled analysis showed that the apnea-hypopnea index (AHI) of the overall study group was significantly lower after using CS (SMD, -1.08; 95% CI, -1.49 to -0.67). Decreases in the AHI were also observed in the normal fluid status (SMD, -1.05; 95% CI, -1.73 to -0.37) and fluid overload status (SMD, -1.17; 95% CI, -1.76 to -0.58) populations. The overall study group had significant decreases in overnight changes in neck circumference (SMD, -1.05; 95% CI, -2.06 to -0.03) and leg fluid volume (SMD, -1.14; 95% CI, -1.88 to -0.41) after using CS. However, no significant differences in overnight changes in neck circumference and leg fluid volume were observed in normal fluid status patients.ConclusionCS may help decrease overnight fluid shift and could be a treatment option for OSA.
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