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Sleep. 2017 Apr 1;40(4). doi: 10.1093/sleep/zsx040.

Effect of Continuous Positive Airway Pressure Treatment on Health-Related Quality of Life and Sleepiness in High Cardiovascular Risk Individuals With Sleep Apnea: Best Apnea Interventions for Research (BestAIR) Trial.

Author information

1
Division of Sleep Medicine and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
2
Harvard Medical School, Boston, MA.
3
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA.
4
Department of Public Health Sciences, University of Chicago, Chicago, IL.
5
Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
6
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
7
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.

Abstract

Study Objectives:

The long-term effect of continuous positive airway pressure (CPAP) on health-related quality of life (HRQOL) in patients with high cardiovascular disease risk and obstructive sleep apnea (OSA) without severe sleepiness is uncertain. We aimed to determine the effect of CPAP treatment on HRQOL in individuals with moderate or severe OSA and cardiovascular disease (CVD) or multiple CVD risk factors without severe sleepiness.

Methods:

In this randomized, controlled, parallel group study, 169 participants were assigned to treatment with CPAP or the control group (conservative medical therapy [CMT] or CMT with sham CPAP). Analyses were based on an intention-to-treat approach. Linear mixed effect models were fitted to compare the changes in the Medical Outcomes Study Short Form-36 (SF-36) and in subjective sleepiness (Epworth Sleepiness Scale [ESS]) between groups from baseline to the average of 6- and 12-month measurements.

Results:

CPAP improved several domains of HRQOL including bodily pain (treatment effect 9.7 [95% confidence interval, CI 3.9 to 15.4]; p = .001), vitality (5.7 [95% CI 1.5 to 9.9]; p = .008), general health (8.2 [95% CI 3.7 to 12.7]; p < .001), physical functioning (5.5 [95% CI 1.1 to 10.0]; p = .016), and the physical health summary score (3.3 [95% CI 1.4 to 5.3]; p = .001). CPAP also resulted in less daytime sleepiness (mean change in ESS -1.0 point [95% CI -2.0 to -0.0]; p = .040).

Conclusions:

In patients with moderate-severe OSA at high risk of cardiovascular events and without severe sleepiness, CPAP improved daytime sleepiness and multiple domains of HRQOL over 6 to 12 months of follow-up, with the largest improvement observed for bodily pain.

KEYWORDS:

CPAP; clinical trial; quality of life; sleep apnea; sleepiness.

PMID:
28419387
PMCID:
PMC5806548
DOI:
10.1093/sleep/zsx040
[Indexed for MEDLINE]
Free PMC Article

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