Ask an answerable question (PICO)：
Obstructive Sleep apnea affects the patient quality of life. Sleep apnea and hypopnea may cause snoring, arousal, hypoxemia and high carbon dioxide and other circumstances. Interruption of sleep will cause lethargy, lack of concentration and memory loss in the daytime. Repeated cycle of sleep process "hypoxia - re-oxygen" and sympathetic excitement may lead to cardiovascular disease which increase the risk of myocardial infarction and stroke in sleeping easily. Therefore, it is extremely important to improve the sleep apnea.
The Method and Analysis of Literature Review：
To review the studies related to the effect of using auricular plaster therapy to reduce the Apnea-Hypopnea Index (AHI) and to provide clinical application for obstructive sleep apnea patients.
A systematic review was conducted. Electronic databases including, Cochrane Library, EBSCO, PubMed , airiti library and CNKI were retrieved for relevant articles. Keywords included “auricular plaster therapy, obstructive sleep apnea syndrome, Apnea-Hypopnea Index (AHI), and polysomnography” with MeSH terms. A total of 14 articles that matched the search criteria were extracted. After screening the topics and deletions repetitions, three randomized controlled trials (RCT) which have level 2 of evidence were selected as the final studies.
According to the GRAD, the quality of these three literatures evidence were intermediate level. In terms of case characteristics, the subjects studied were all adult patients diagnosed with obstructive sleep apnea (> 18 years). The auricular plaster therapy was given at Ear Shengmen, Jiaogan, Pizhixia, Heart, Lung, Spleen, Kidney, Chuiqian and throat with Wang Bu Liu Xing (Vaccaria Seed) or magnetic beads, and the auricular points were pressed 3-5 times a day. Pressing one ear for each time (right side first). Execution time has different definition for each reference. First one define ten days as a treatment course, secondary define once a week for total twelve weeks. Third define twice a week for total two weeks only. Use Apnea-Hypopnea Index (AHI) to evaluate the improvement of obstructive sleep apnea after the experiment by polysomnography (PSG). Three studies were statistically significant (p< .01; p< .05; p< .05). The Cohen's d of the three literature is between 0.47 and 1.45, which is the medium-to-high effect size.
Conclusions and Recommendations：
According to the GRADE evidence to recommendation, the intervention of these three literature was strong recommendation. Because it clealy show that desirable effects of an intervention outweigh its undesirable effects. The clinical protocol of auricular plaster therapy on obstructive sleep apnea can be standardized to provide clinical application. To establish auricular plaster therapy interventional effect on obstructive sleep apnea syndrome.