Sleep Apnea
Study register · detail Meta-Analyse · Sleep Apnea · 2026

Sleep apnea and substance use: a meta-analysis.

No direction reported GRADE High
Samplek = 28 Studien
DesignMeta-Analyse
Summary

Meta-analysis on substance use and sleep apnea, k=28 studies from 3784 screening hits. Higher AHI in alcohol users (SMD: 0,46, 95% CI [0,21-0,71], z=3,62, p<0.001) and increased central sleep apnea prevalence in opioid users (SMD: 0,44, 95% CI [0,24-0,64], z=4,37, p<0.001). Only one study on cannabis users vs. non-users identified. Sex and age as potential moderators.

Confidence in the evidence
High

The highest of four GRADE levels, the effect estimate is very reliable.

Quality profile
Sample size
Blinding
Effect size
Citations / year
Authors
Mauries S, Rolland B, Frija-Masson J, d'Ortho MP, Catoire S, Zehani F, Davido G, Lejoyeux M, Geoffroy PA
DOI 10.1016/j.smrv.2025.102228
Design: Meta-Analyse
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Abstract
Introduction: Sleep apnea and substance use disorders appear to interact bidirectionally, negatively influencing each other. Obstructive sleep apnea syndrome (OSA) seems particularly prevalent among substance users. Methods: This meta-analysis aims to evaluate the impact of the most commonly used substances (alcohol, tobacco, cannabis, opioids, and cocaine) on the apnea-hypopnea index (AHI) by comparing the mean AHI scores between users and non-users. Results: 3784 articles were identified from the PubMed search, and 28 studies were included in the meta-analysis. We found a higher AHI among alcohol users (SMD: 0.46, 95 % CI [0.21-0.71] (z = 3.62; p < 0.001)) and a higher prevalence of central sleep apnea among opioid users (SMD: 0.44 95 % CI 0.24-0.64] (z = 4.37; p < 0.001)). The AHI was also elevated among tobacco users, although this difference was not statistically significant. Regarding moderators effects, sex may influence alcohol's impact, while both age and sex could affect the relationship between opioids and AHI. No studies compared the AHI of cocaine users to non-users, and only one study comparing the AHI of cannabis users to non-users were found. Conclusion: This study highlights the importance of diagnosing and managing sleep apnea in patients with substance use, in order to improve addiction prognosis through specific treatment approaches.

The impediment to action advances action. — Marcus Aurelius