Sleep and Breathing

, Volume 23, Issue 1, pp 5–12 | Cite as

Impact of continuous positive airway pressure on vascular endothelial growth factor in patients with obstructive sleep apnea: a meta-analysis

  • Jia-Chao Qi
  • LiangJi Zhang
  • Hao Li
  • Huixue Zeng
  • Yuming Ye
  • Tiezhu Wang
  • Qiyin Wu
  • Lida Chen
  • Qiaozhen Xu
  • Yifeng Zheng
  • Yaping Huang
  • Li LinEmail author
Sleep Breathing Physiology and Disorders • Review



Cumulative evidence supports the clear relationship of obstructive sleep apnea (OSA) with cardiovascular disease (CVD). And, adherence to continuous positive airway pressure (CPAP) treatment alleviates the risk of CVD in subjects with OSA. Vascular endothelial growth factor (VEGF), a potent angiogenic cytokine regulated by hypoxia-inducible factor, stimulates the progression of CVD. Thus, whether treatment with CPAP can actually decrease VEGF in patients with OSA remains inconclusive. The purpose of the present study was to quantitatively evaluate the impact of CPAP therapy on VEGF levels in OSA patients.


We systematically searched Web of Science, Cochrane Library, PubMed, and Embase databases that examined the impact of CPAP on VEGF levels in OSA patients prior to May 1, 2017. Related searching terms were “sleep apnea, obstructive,” “sleep disordered breathing,” “continuous positive airway pressure,” “positive airway pressure,” and “vascular endothelial growth factor.” We used standardized mean difference (SMD) to analyze the summary estimates for CPAP therapy.


Six studies involving 392 patients were eligible for the meta-analysis. Meta-analysis of the pooled effect showed that levels of VEGF were significantly decreased in patients with OSA before and after CPAP treatment (SMD = − 0.440, 95% confidence interval (CI) = − 0.684 to − 0.196, z = 3.53, p = 0.000). Further, results demonstrated that differences in age, body mass index, apnea–hypopnea index, CPAP therapy duration, sample size, and racial differences also affected CPAP efficacy.


Improved endothelial function measured by VEGF may be associated with CPAP therapy in OSA patients. The use of VEGF levels may be clinically important in evaluating CVD for OSA patients. Further large-scale, well-designed long-term interventional investigations are needed to clarify this issue.


Obstructive sleep apnea Cardiovascular disease Positive airway pressure Vascular endothelial growth factor 


Author contribution

Jia-Chao Qi and LiangJi Zhang contributed equally to this work.

Funding information

This work was supported by grant 2017-1-87 for Youth Research Fund from Fujian Provincial Health Bureau.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Jia-Chao Qi
    • 1
  • LiangJi Zhang
    • 1
  • Hao Li
    • 1
  • Huixue Zeng
    • 1
  • Yuming Ye
    • 1
  • Tiezhu Wang
    • 1
  • Qiyin Wu
    • 1
  • Lida Chen
    • 1
  • Qiaozhen Xu
    • 1
  • Yifeng Zheng
    • 1
  • Yaping Huang
    • 1
  • Li Lin
    • 1
    Email author
  1. 1.Department of Respiratory MedicineZhangzhou Affiliated Hospital of Fujian Medical UniversityZhangzhouPeople’s Republic of China

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