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