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Eur Respir J. 2015 Jul;46(1):142-51. doi: 10.1183/09031936.00064214. Epub 2015 May 28.

Obstructive sleep apnoea in the elderly: role of continuous positive airway pressure treatment.

Author information

1
Respiratory Dept, Hospital Universitario y Politécnico La Fe, Valencia, Spain CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Bunyola, Spain mianmartinezgarcia@gmail.com.
2
Respiratory Dept, Hospital Universitario San Juan, Alicante, Spain.
3
Respiratory Dept, Hospital General Universitario, Alicante, Spain.
4
Respiratory Dept, Hospital La Plana, Castellón, Spain.
5
Respiratory Dept, Hospital General Requena, Valencia, Spain.
6
Respiratory Dept, Hospital Universitario Peset, Valencia, Spain.
7
Respiratory Dept, Hospital Universitario, Castellón, Spain.
8
Respiratory Dept, Hospital Torrevieja, Alicante, Spain.
9
Respiratory Dept, Hospital de Sabadell, Corporació Sanitaria Parc Tauli, Barcelona, Spain.
10
CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Bunyola, Spain Respiratory Dept, Hospital Universitario Virgen del Rocio, Sevilla, Spain.
11
Respiratory Dept, IDIBAPS-Hospital Clinic, Barcelona, Spain.
12
Araba Health Research Unit, BioAraba, Osakidetza, Vitoria, Spain.
13
Respiratory Dept, Hospital Universitario Vall Hebrón, Barcelona, Spain.
14
Respiratory Dept, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain.
15
Respiratory Dept, Hospital Universitario y Politécnico La Fe, Valencia, Spain.

Abstract

Almost all the information about the effect of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnoea (OSA) comes from clinical trials involving only middle-aged patients. The objective of this study was to assess the effect of CPAP treatment in elderly patients with severe OSA on clinical, quality-of-life and neurocognitive spheres. We performed an open-label, randomised, multicentre clinical trial in a consecutive clinical cohort of 224 elderly (≥70 years old) patients with confirmed severe OSA (apnoea-hypopnea index ≥30) randomised to receive CPAP (n=115) or no CPAP (n=109) for 3 months. A sleep study was performed by either full polysomnography or respiratory polygraphy. CPAP titration was performed by an autoCPAP device. The primary endpoint was quality of life (Quebec Sleep Questionnaire) and secondary endpoints included sleep-related symptoms, presence of anxiety/depression, office-based blood pressure and some neurocognitive tests. The mean±sd age was 75.5±3.9 years. The CPAP group achieved a greater improvement in all quality-of-life domains (p<0.001; effect size: 0.41-0.98), sleep-related symptoms (p<0.001; effect size 0.31-0.91) as well as anxiety (p=0.016; effect size 0.51) and depression (p<0.001; effect size: 0.28) indexes and some neurocognitive tests (digit symbol test (p=0.047; effect size: 0.20) and Trail Making Test A (p=0.029; effect size: 0.44)) in an intention-to-treat analysis. In conclusion, CPAP treatment resulted in an improvement in quality of life, sleep-related symptoms, anxiety and depression indexes and some neurocognitive aspects in elderly people with severe OSA.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT02069600.

PMID:
26022945
DOI:
10.1183/09031936.00064214
[Indexed for MEDLINE]
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