BACKGROUND Cerebral small vessel disease (CSVD) is a well-known cause of vascular dementia, a leading medical morbidity in the aging population. Obstructive sleep apnea (OSA) has been validated as a cardiovascular risk factor. However, the relationship between these two clinical syndromes is not well established. We aimed to assess the association between OSA and CSVD. METHODS Databases were searched from inception through May 2019. Studies that reported incidence or odd ratios of CSVD in patients with OSA were included. Effect estimates from the individual studies were extracted and combined using random-effect, generic inverse variance method of DerSimonian and Laird. RESULTS A total of 14 observational studies comprising of 4335 patients were included into the analysis. Compared to patients without OSA, patients with OSA were significantly associated with CSVD magnetic resonance imaging (MRI) findings of white matter hyperintensity (WMH) and asymptomatic lacunar infarction (ALI) with a pooled OR of 2.31 (95% confidence interval [CI], 1.46-3.66, I2 = 79%) and 1.78 (95% CI, 1.06-3.01, I2 = 41%), respectively. However, there was no significant association between OSA and findings of cerebral microbleeds (CMBs), with a pooled odds ratio (OR) of 2.15 (95% CI, 0.64-7.29, I2 = 55%). CONCLUSIONS Our study demonstrated the association between OSA and CSVD MRI findings of white matter hyperintensity (WMH) and asymptomatic lacunar infarction (ALI) when compared to patients without OSA. The absence of an association of CMBs findings with OSA could be due either by a lower sensitivity of neuroimaging techniques utilized to detect CMBs or a potentially different pathogenesis of CMBs.

中文翻译：

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阻塞性睡眠呼吸暂停对无症状脑小血管疾病的影响：系统评价和荟萃分析。

背景技术脑小血管病（CSVD）是血管性痴呆的众所周知的原因，血管性痴呆是老龄化人群中的主要医学疾病。阻塞性睡眠呼吸暂停 (OSA) 已被证实为心血管危险因素。然而，这两种临床综合征之间的关系尚不明确。我们旨在评估 OSA 和 CSVD 之间的关联。方法从开始到 2019 年 5 月搜索数据库。纳入报告 OSA 患者 CSVD 发病率或奇数比的研究。使用 DerSimonian 和 Laird 的随机效应、通用逆方差方法提取和组合单个研究的效果估计值。结果 共有 14 项观察性研究包括 4335 名患者被纳入分析。与没有 OSA 的患者相比，OSA 患者与脑白质高信号 (WMH) 和无症状腔隙性脑梗死 (ALI) 的 CSVD 磁共振成像 (MRI) 发现显着相关，合并 OR 为 2.31（95% 置信区间 [CI]，1.46-3.66，I2 = 79%) 和 1.78 (95% CI, 1.06-3.01, I2 = 41%)。然而，OSA 与脑微出血 (CMB) 发现之间没有显着关联，合并优势比 (OR) 为 2.15 (95% CI, 0.64-7.29, I2 = 55%)。结论 我们的研究表明，与没有 OSA 的患者相比，OSA 和 CSVD MRI 发现的白质高信号 (WMH) 和无症状腔隙性脑梗死 (ALI) 之间存在关联。