Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis

Objective:A systematic review and meta-analysis of the association between alcohol consumption and risk of sleep apnoea in adults.Methods:We searched Medline, EMBASE and Web of Science databases from 1985 to 2015 for comparative epidemiological studies assessing the relation between alcohol consumption and sleep apnoea. Two authors independently screened and extracted data. Random effects meta-analysis was used to estimate pooled effect sizes with 95% confidence intervals (CI). Heterogeneity was quantified using I[superscript]2 and explored using subgroup analyses based on study exposure and outcome measures, quality, design, adjustment for confounders and geographical location. Publication bias was assessed using a funnel plot and Egger’s test.Results:We identified 21 studies from which estimates of relative risk could be obtained. Meta-analysis of these estimates demonstrated that higher levels of alcohol consumption increased the risk of sleep apnoea by 25% (RR 1.25, 95%CI 1.13-1.38, I[superscript]2=82%,