Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 Dec:42:59-67.
doi: 10.1016/j.smrv.2018.05.007. Epub 2018 Jun 11.

The impact of alcohol on breathing parameters during sleep: A systematic review and meta-analysis

Bhanu Prakash Kolla  1 , Moein Foroughi  2 , Farzane Saeidifard  3 , Subhajit Chakravorty  4 , Zhen Wang  5 , Meghna P Mansukhani  6
Affiliations
Meta-Analysis

The impact of alcohol on breathing parameters during sleep: A systematic review and meta-analysis

Bhanu Prakash Kolla et al. Sleep Med Rev. 2018 Dec.

Abstract

Alcohol, a muscle relaxant, can potentially worsen obstructive sleep apnea (OSA) but the literature on the effects of alcohol on OSA is conflicting. This systematic review and meta-analysis of randomized controlled trials examined the impact of alcohol on breathing parameters during sleep. Ovid Medline, Embase and PsycINFO databases were queried through November 1, 2017 for studies that reported objective measures of breathing during sleep, prior to and after alcohol administration. Weighted mean differences (WMD) and 95% confidence intervals (CI) were calculated for apnea-hypopnea index (AHI) and mean oxyhemoglobin saturation (SpO2). Secondary outcome measures were examined where available. The meta-analysis of 14 eligible studies (n = 422; 71.9% male) found that AHI increased significantly after alcohol administration (WMD = 2.33; 95% CI = 1.41 to 3.25, I2 = 62%) and mean SpO2 was significantly reduced (WMD = -0.60; 95% CI = -0.72 to -0.49, I2 = 0%). The increase in AHI was greater in snorers (WMD = 4.20; 95% CI = 1.19 to 6.50, I2 = 0%) and those with a diagnosis of OSA (WMD = 7.10; 95% CI = 3.59 to 10.61, I2 = 0%). Additionally, a significant increase in respiratory event duration (WMD = 0.86; 95% CI = 0.18 to 1.55, I2 = 19%) and decrease in nadir SpO2 (WMD = -1.25; 95% CI = -2.00 to -0.50, I2 = 25%) were noted. Alcohol is a modifiable risk factor that can result in the development or worsening of OSA.

Keywords: Alcohol; Oxygen saturation; Sleep apnea.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: The other authors have no conflict of interest or funding to report.

Figures

Figure 1.
Figure 1.
Flow diagram of studies included in the meta-analyses
Figure 2
Figure 2
a. Funnel plot of studies comparing AHI Figure 2 b. Funnel plot of studies comparing mean SpO2
Figure 2
Figure 2
a. Funnel plot of studies comparing AHI Figure 2 b. Funnel plot of studies comparing mean SpO2
Figure 3.
Figure 3.
Forest plot of mean difference in AHI on alcohol exposed nights V. Placebo nights
Figure 4.
Figure 4.
Forest plot of mean difference in mean SpO2 on alcohol exposed nights V. Placebo nights
Figure 5.
Figure 5.
Forest plot of mean difference in apnea-hypopnea index on alcohol-exposed nights versus placebo nights in subjects with OSA.
See this image and copyright information in PMC

References

    1. Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014;383(9918):736–47. - PMC - PubMed
    1. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342(19):1378–84. - PubMed
    1. Punjabi NM, Caffo BS, Goodwin JL, Gottlieb DJ, Newman AB, O’Connor GT, et al. Sleep-disordered breathing and mortality: a prospective cohort study. PLoS medicine. 2009;6(8):e1000132. - PMC - PubMed
    1. Gottlieb DJ, Yenokyan G, Newman AB, O’Connor GT, Punjabi NM, Quan SF, et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation. 2010;122(4):352–60. - PMC - PubMed
    1. Cadby G, McArdle N, Briffa T, Hillman DR, Simpson L, Knuiman M, et al. Severity of OSA is an independent predictor of incident atrial fibrillation hospitalization in a large sleep-clinic cohort. Chest. 2015;148(4):945–52. - PubMed

MeSH terms