膝、髋和手骨关节炎患者睡眠障碍的患病率：一项系统评价与荟萃分析

文献信息

中文摘要

目的： 估计膝、髋或手骨关节炎患者中失眠、阻塞性睡眠呼吸暂停、不宁腿综合征和发作性睡病的合并患病率。
设计： 患病率系统评价与荟萃分析。该评价方案已在PROSPERO预注册（CRD420251005836）。
文献检索： 我们在Embase、MEDLINE和Cochrane Library中进行了从建库至2025年8月的系统检索，并辅以引文筛选和参考文献核查。
研究选择标准： 我们纳入了报告膝、髋或手骨关节炎患者睡眠障碍患病率数据的观察性研究和干预性研究。
数据合成： 使用纽卡斯尔-渥太华量表评估偏倚风险，并使用推荐分级的评估、制定与评价工具评价证据确定性。采用随机效应比例荟萃分析计算合并患病率估计，并根据诊断标准和患者特征进行亚组分析。
结果： 共纳入18项研究（202 847名参与者）（3项队列研究、5项病例对照研究、12项横断面研究），其中9项研究质量很好至良好或高质量。失眠是最常见的睡眠障碍，为42%（95%置信区间[CI]：34%至51%），其次是睡眠呼吸暂停（37%[95%CI：6%至67%]）和不宁腿综合征（35%[95%CI：10%至61%]）。没有研究报告发作性睡病。各研究的估计值因诊断标准和样本特征而异，证据确定性极低。
结论： 睡眠障碍，尤其是失眠，在膝、髋或手骨关节炎患者中很常见，支持需要提高临床认识。未来的研究可能会改变患病率估计，因为仅识别出少量高质量研究，且观察到较大的研究间异质性。J Orthop Sports Phys Ther 2026;56(11):710-723。电子版发布于2026年8月27日。doi:10.2519/jospt.2026.14210。

英文摘要

OBJECTIVE: To estimate the pooled prevalences of insomnia, obstructive sleep apnea, restless legs syndrome, and narcolepsy in patients with knee, hip, or hand osteoarthritis. DESIGN: Prevalence systematic review with meta-analyses. The review protocol was preregistered at PROSPERO (CRD420251005836). LITERATURE SEARCH: We conducted systematic searches in Embase, MEDLINE, and the Cochrane Library from inception to August 2025, supplemented by citation screening and reference checking. STUDY SELECTION CRITERIA: We identified observational and interventional studies reporting prevalence data on sleep disorders among patients with knee, hip, or hand osteoarthritis. DATA SYNTHESIS: Risk of bias was assessed using the Newcastle-Ottawa Scale, and certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation tool. Pooled prevalence estimates were calculated using random-effects proportion meta-analyses, with subgroup analyses based on diagnostic criteria and patient characteristics. RESULTS: Eighteen studies (202 847 participants) were included (three cohort, five case-control, 12 cross-sectional), of which nine studies were of very good to good or high quality. Insomnia was the most prevalent sleep disorder, 42% (95% confidence interval [CI]: 34% to 51%), followed by sleep apnea (37% [95% CI: 6% to 67%]) and restless legs syndrome (35% [95% CI: 10% to 61%]). No studies reported on narcolepsy. Estimates varied by diagnostic criteria and sample characteristics across studies, and the certainty of evidence was very low. CONCLUSION: Sleep disorders, particularly insomnia, were common among patients with knee, hip, or hand osteoarthritis, supporting the need to raise clinical awareness. Future studies may alter prevalence estimates, as only a small number of high-quality studies were identified and large between-study heterogeneity was observed. J Orthop Sports Phys Ther 2026;56(11):710-723. Epub 27 Aug 2026. doi:10.2519/jospt.2026.14210.