Investigating the effect of valsartan/sacubitril on sleep parameters of patients with sleep apnea: systematic review and meta-analysis.

OBJECTIVES: Sleep apnea, often linked to heart failure, may benefit from sacubitril/valsartan (SV), a promising treatment shown to improve sleep quality and variables. This review and meta-analysis assess the sleep-related effects of SV in patients with sleep apnea. METHODS: This systematic review and meta-analysis involved a search of several databases, including Embase, Web of Science, PubMed/Medline, Cochrane, and Scopus, conducted through October 2024. The results, comparing post-intervention effects of valsartan/sacubitril versus pre-intervention values, were evaluated across different groups: Overall, Central, and Obstructive. The analysis focused on several sleep parameters, including SpO2 < 90% (%), mean SpO2 (%), OAI (Obstructive Apnea Index, events/h), CAI (Central Apnea Index, events/h), and AHI (Apnea-Hypopnea Index, events/h). FINDINGS: Six studies, including 12 records from non-controlled intervention studies, were analyzed. Significant reductions in AHI were observed across all groups post-intervention, with the most notable decrease in the Obstructive group (SMD = -0.74, 95% CI: -1.15 to -0.33, P = 0.004). A decrease was also seen in the Overall group (SMD = -0.48, 95% CI: -0.62 to -0.33, P < 0.001) and the Central group (SMD = -0.47, 95% CI: -0.78 to -0.16, P = 0.003). Additionally, CAI values decreased in all groups, while OAI and mean SpO2 values increased. CONCLUSION: The results of this study suggest that treatment with SV medication in patients suffering from sleep apnea typically results in improvements in sleep parameters like CAI and AHI, leading to a notable improvement in their overall sleep quality. CLINICAL TRIAL REGISTRATION NUMBER: Not required