Continuous positive airway pressure, well established as an effective treatment for severe obstructive sleep apnea, also is effective in patients with mild and moderately severe OSA and daytime sleepiness, according to a study.
Evidence for the efficacy of CPAP in patients with milder OSA has been "limited and conflicting," Terri E. Weaver, RN, PhD, the study’s lead author and professor and dean at the University of Illinois at Chicago’s College of Nursing, said in a news release.
The multisite, double-blind and randomized trial, which Weaver said is the first placebo-controlled study to use sham CPAP in sleepy patients with mild to moderate OSA, "shows that CPAP treatment effectively reduces symptoms and improves quality of life in these patients, the largest segment of the OSA population."
In the study, 239 patients with newly diagnosed milder OSA and self-reported daytime sleepiness (an Epworth Sleepiness Scale score of more than 10) were randomized to eight weeks of active or sham CPAP treatment. After the eight-week intervention, patients in the sham arm were crossed over to eight weeks of active treatment. The primary outcome measure was total score on the Functional Outcomes of Sleep Questionnaire, which measures the impact of daytime sleepiness on activities of daily living.
The adjusted average change in FOSQ total score after the initial eight-week intervention was 0.89 for actively treated patients and -0.06 for sham-treated patients. Average improvement in FOSQ total score from the beginning to the end of the crossover phase of the study was 1.73 (plus or minus 2.5). Significant improvements with active treatment were also seen in ESS scores, physical component scores on the Short-Form 36 health survey and total mood disturbance scores on the Profile of Mood States scale.
"The improvements we saw were highly significant and clinically relevant," Weaver said. "In addition, our study was conducted at both large and smaller clinical practice sites, making our results highly generalizable."
The researchers noted limitations with the study, including a short average duration of active daily CPAP treatment (four hours, plus or minus two hours a day) and a lower average duration of sham daily CPAP treatment (3.1 hours, plus or minus 2.1 hours a day).
"Given the high prevalence of OSA, our study suggests that there is significant value in treating sleepy patients with mild to moderate disease," Weaver said. "CPAP therapy, the primary treatment for OSA, is highly effective and confers significant health benefits in these patients."
The study is scheduled for publication in the American Journal of Respiratory and Critical Care Medicine, a journal of the American Thoracic Society.
Evidence for the efficacy of CPAP in patients with milder OSA has been "limited and conflicting," Terri E. Weaver, RN, PhD, the study’s lead author and professor and dean at the University of Illinois at Chicago’s College of Nursing, said in a news release.
The multisite, double-blind and randomized trial, which Weaver said is the first placebo-controlled study to use sham CPAP in sleepy patients with mild to moderate OSA, "shows that CPAP treatment effectively reduces symptoms and improves quality of life in these patients, the largest segment of the OSA population."
In the study, 239 patients with newly diagnosed milder OSA and self-reported daytime sleepiness (an Epworth Sleepiness Scale score of more than 10) were randomized to eight weeks of active or sham CPAP treatment. After the eight-week intervention, patients in the sham arm were crossed over to eight weeks of active treatment. The primary outcome measure was total score on the Functional Outcomes of Sleep Questionnaire, which measures the impact of daytime sleepiness on activities of daily living.
The adjusted average change in FOSQ total score after the initial eight-week intervention was 0.89 for actively treated patients and -0.06 for sham-treated patients. Average improvement in FOSQ total score from the beginning to the end of the crossover phase of the study was 1.73 (plus or minus 2.5). Significant improvements with active treatment were also seen in ESS scores, physical component scores on the Short-Form 36 health survey and total mood disturbance scores on the Profile of Mood States scale.
"The improvements we saw were highly significant and clinically relevant," Weaver said. "In addition, our study was conducted at both large and smaller clinical practice sites, making our results highly generalizable."
The researchers noted limitations with the study, including a short average duration of active daily CPAP treatment (four hours, plus or minus two hours a day) and a lower average duration of sham daily CPAP treatment (3.1 hours, plus or minus 2.1 hours a day).
"Given the high prevalence of OSA, our study suggests that there is significant value in treating sleepy patients with mild to moderate disease," Weaver said. "CPAP therapy, the primary treatment for OSA, is highly effective and confers significant health benefits in these patients."
The study is scheduled for publication in the American Journal of Respiratory and Critical Care Medicine, a journal of the American Thoracic Society.
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