Association between sleep-disordered breathing and lower extremity artery disease: a meta-analysis.

Abstract

Previous studies suggest a relationship between sleep disordered breathing (SDB) and lower extremity artery disease (LEAD) though disagreements remain. This study was performed to assess the association between SDB and LEAD in a metaanalysis. PubMed and Embase databases were searched for observational studies. A random-effects model incorporating between-study heterogeneity was used to pool the data. The search revealed 7 studies including 152,885 participants. Patients with SDB had higher odds of LEAD (risk ratio [RR] = 1.32, 95% confidence interval [CI] = 1.07 to 1.63, p = 0.01, I 2 = 66%) compared to non-SDB participants. In subgroup analyses, SDB was related to higher odds of LEAD in patients with stroke or diabetes (RR = 3.28, p < 0.001) than in a community-derived population (RR = 1.17, p = 0.08; p for subgroup difference < 0.001). Furthermore, the odds of LEAD was increased in patients with moderate (RR = 1.34, 95% CI = 1.04 to 1.73, p = 0.02) or severe SDB (RR = 1.81, 95% CI = 1.08 to 3.03, p = 0.02), but not in those with mild SDB (RR = 0.94, 95% CI = 0.69 to 1.29, p = 0.71). Differences in study design or methods for LEAD diagnosis did not appear to affect the association between SDB and LEAD. Patients with SDB have higher odds of LEAD compared to non-SDB participants.