Available online 6 April 2023, 101239

To clarify the correlation between preexisting obstructive sleep apnea (OSA) and postoperative delirium (POD) in patients undergoing surgeries with anesthesia or intensive care unit (ICU) admission.

Publications published from inception to May 2021 were retrieved from PubMed, Embase, and the Cochrane Library. Risk ratio (RR) and the 95% confidence interval (CI) were used to assess the association between preexisting OSA and POD in patients undergoing surgeries. Subgroup analysis stratified by study design, sample size or patient's mean age was performed.

Ten studies (51,863 patients and 5041 delirium cases) were included. Compared with patients without OSA, those with OSA showed a higher POD risk (RR = 1.63, 95CI: 1.20–2.20, P＜0.001). Subgroup analysis by study design or sample size showed non-significant pooled RR. A large-sample study with non-significant results was found to have a large impact on the pooled results in sensitivity analysis, which may greatly reduce the effect size. Notably, age could be a moderator in the association of OSD & POD.

Preexisting OSA was found to be associated with POD in patients undergoing major surgeries in our meta-analysis. However, larger studies are needed to confirm this results in the future considering the high heterogeneity in existing research.

Obstructive sleep apnea

Postoperative delirium

Systematic review

Meta-analysis

© 2023 Published by Elsevier Ltd.