Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational epidemiological studies
PubMed 29458744 · doi:10.1016/j.sleep.2017.12.005
What was done
A systematic review and random-effects meta-analysis was conducted across Medline, EMBASE, and Web of Science (1985–2015) to evaluate comparative epidemiological studies investigating alcohol consumption and sleep apnoea risk in adults. Two authors independently screened records and extracted data. Heterogeneity was assessed using I² and subgroup analyses (exposure/outcome definitions, study quality, study design, adjustment for confounders, and geography). Publication bias was evaluated via funnel plots and Egger's test.
What was found
Across 21 studies providing relative risk data, higher alcohol intake was associated with a 25% increased risk of sleep apnoea (RR 1.25, 95% CI 1.13–1.38, p < 0.0001), with high heterogeneity (I² = 82%). The association was larger in low- and middle-income countries but remained consistent across variations in study design, quality, and exposure/outcome definitions. Egger's test indicated significant publication bias (p = 0.001). In a separate meta-analysis of 8 studies reporting continuous intake, individuals with sleep apnoea drank an average of 2 units/week more than controls, but this difference was not statistically significant (p = 0.41).
Why it matters
This review aggregates epidemiological data demonstrating an association between alcohol intake and sleep apnoea risk, supporting recommendations to assess and moderate alcohol consumption in clinical management and prevention.
Limits
The underlying evidence consists entirely of observational studies susceptible to residual confounding. There was substantial statistical heterogeneity (I² = 82%) and significant publication bias (p = 0.001). Total participant count, dose-response details, and specific definitions of alcohol intake and sleep apnoea severity were not detailed in the abstract.
Cited by
- supports A meta-analysis of 21 observational studies found that alcohol consumption was associated with a 25% higher risk of sleep apnea.