Continuous Positive Airway Pressure Improves Quality of Life in Women with Obstructive Sleep Apnea. A Randomized Controlled Trial

Campos‐Rodríguez, Francisco; Queipo-Corona, Carlos; Carmona-Bernal, Carmen; Jurado-Gámez, Bernabé; Cordero-Guevara, José; Reyes-Núñez, Nuria; Troncoso-Acevedo, Fernanda; Abad-Fernández, Araceli; Terán-Santos, Joaquín; Caballero-Rodriguez, Julian; Martin-Romero, Mercedes; Encabo-Motiño, Ana; Sacristan-Bou, Lirios; Navarro-Esteva, Javier; Somoza‐González, María; Masa, Juan F.; Sánchez-Quiroga, M-Ángeles; Jara-Chinarro, Beatriz; Orosa-Bertol, Belen; Martínez-García, Miguel Ángel

doi:10.1164/rccm.201602-0265oc

Cited by 79 publications

(59 citation statements)

References 45 publications

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“…As previously summarized, CPAP was effective in some studies (Campos‐Rodriguez et al., ; Diamanti et al., ) and not in some others (Barnes et al., ; Gagnadoux et al., ). CPAP treatment did not resolve depressive symptoms in many OSA patients and persistent depressive symptoms were strongly associated with EDS (Gagnadoux et al., ).…”

Section: Discussionmentioning

confidence: 93%

“…In a recent RCT, with 307 female patients with moderate to severe OSA, Campos‐Rodriguez et al. showed significant improvement in depression after 3 months of CPAP therapy compared to conservative treatment (Campos‐Rodriguez et al., ). In a meta‐analysis, including 19 trials, CPAP treatment was shown to be effective in improving depression and a greater benefit of treatment was observed especially in patients with higher depression scores at baseline (Povitz et al., ).…”

Section: Discussionmentioning

confidence: 99%

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Determinants of depressive mood in coronary artery disease patients with obstructive sleep apnea and response to continuous positive airway pressure treatment in non‐sleepy and sleepy phenotypes in the RICCADSA cohort

Balcan

Thunström

Strollo

et al. 2019

Journal of Sleep Research

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We explored determinants of depressive mood in adults with coronary artery disease and obstructive sleep apnea and response to positive airway pressure treatment in sleepy and non‐sleepy phenotypes. In this secondary analysis of the RICCADSA trial conducted in Sweden, 493 cardiac patients with obstructive sleep apnea (n = 386) or no obstructive sleep apnea (n = 107) with complete Epworth Sleepiness Scale and Zung Self‐rating Depression Scale questionnaires were included. Sleepy (Epworth Sleepiness Scale ≥10) versus non‐sleepy (Epworth Sleepiness Scale <10) patients with depressive mood (Zung Self‐rating Depression Scale score ≥50) were evaluated after 3 and 12 months of positive airway pressure treatment. In all, 133 patients (27.0%) had depressive mood (29.3% of obstructive sleep apnea versus 18.7% of no obstructive sleep apnea; p = 0.029), with a higher percentage among the sleepy phenotype (36.9% versus 24.5%; p = 0.009). In multivariate analysis, depressive mood was significantly associated with female sex, body mass index and Epworth Sleepiness Scale. Among 97 obstructive sleep apnea patients with depressive mood at baseline, there was a significant reduction in the scores at follow‐up both in the sleepy and non‐sleepy patients allocated to positive airway pressure treatment, whereas no significant changes were observed in the untreated group (p = 0.033). The device use (hr/night) predicted improvement in mood (odds ratio, 1.33; 95% confidence interval, 1.10–1.61; p = 0.003) adjusted for age, female sex, body mass index, left ventricular ejection fraction, apnea–hypopnea index and delta Epworth Sleepiness Scale score. We conclude that obstructive sleep apnea was associated with depressive mood in adults with coronary artery disease. Treatment with positive airway pressure improved mood in both phenotypes, independent of the confounding factors.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Determinants of depressive mood in coronary artery disease patients with obstructive sleep apnea and response to continuous positive airway pressure treatment in non‐sleepy and sleepy phenotypes in the RICCADSA cohort

Balcan

Thunström

Strollo

et al. 2019

Journal of Sleep Research

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“…The main strengths of our work include the use of older mice that were 18 months of age and the use of a conventional mouse strain, which allowed us to assess the cardiovascular consequences associated with IH exposure without other confounding factors or co‐morbidities. In addition, we used female mice rather than male mice due to the absence of relevant studies in female mice and the late emergence of sexually dimorphic cardiovascular outcomes with increased susceptibility in women …”

Section: Discussionmentioning

confidence: 99%

Effect of age on the cardiovascular remodelling induced by chronic intermittent hypoxia as a murine model of sleep apnoea

et al. 2019

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Background and objective Chronic intermittent hypoxia (CIH) is a major determinant of the cardiovascular morbidity associated with obstructive sleep apnoea (OSA), and the magnitude of CIH impact may be influenced by ageing. Here, we assessed the role of ageing in the early cardiovascular structural remodelling induced by severe CIH in a murine model of OSA. Methods Cardiovascular remodelling was assessed in young (2 months old, n = 20) and aged (18 months old, n = 20) C57BL/6 female mice exposed to CIH (20% O2 for 40 s, 5% O2 for 20 s) or normoxia (room air) for 8 weeks (6 h/day). Results Early vascular remodelling was observed in young mice exposed to CIH as illustrated by intima‐media thickening (mean change: 4.6 ± 2.6 μm; P = 0.02), elastin fibre disorganization (mean change: 9.2 ± 4.5%; P = 0.02) and fragmentation (mean change: 2.5 ± 0.8%; P = 0.03), and collagen (mean change: 3.2 ± 0.6%; P = 0.001) and mucopolysaccharide accumulation (mean change: 2.4 ± 0.8%; P = 0.01). In contrast, vascular remodelling was not apparent in aged mice exposed to CIH. Furthermore, left ventricular perivascular fibrosis (mean change: 0.71 ± 0.1; P < 0.001) and hypertrophy (mean change: 0.17 ± 0.1; P = 0.038) were increased by CIH exposure in young mice, but not in aged mice. Principal component analysis identified similar cardiovascular alterations among the young mice exposed to CIH and both older mouse groups, suggesting that CIH induces premature cardiovascular senescence. Conclusion Cardiovascular remodelling induced by severe CIH is affected by the age at which CIH onset occurs, suggesting that the deleterious cardiovascular effects associated with CIH may be more pronounced in younger populations, and such changes resemble chronological age‐related declines in cardiovascular structural integrity.

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“…27 A RCT involving only women showed improvement in QoL measures after 3 months of PAP therapy as determined by the Quebec Sleep Questionnaire. 28 A recent meta-analyses showed improvement in the medical and physical components of SF-36 with the use of CPAP therapy 29 in patients with OSA. A recent study showed that individuals with severe OSA who lived in lower income neighborhoods did not face obstacles in obtaining PAP treatment; however, they did observe that those living in higher income neighborhoods had a 27% higher rate of PAP acceptance.…”

Section: Discussionmentioning

confidence: 99%

Impact of Sleep-Disordered Breathing Treatment on Quality of Life Measures in a Large Clinic-Based Cohort

Walia

Thompson

Katzan

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: This study aims to report the effect of positive airway pressure (PAP) therapy on quality of life (QoL) measures in the clinical sleepdisordered breathing (SDB) population. Methods: We examined general QoL measures assessed by European Quality of Life-5D (EQ-5D) and sleep-specific QoL by examining Functional Outcomes of Sleep Questionnaire (FOSQ) scores before and after PAP therapy retrospectively in a clinical SDB population using paired and two-sample t tests. Age and socioeconomic status (SES) effect modification on pre-PAP QoL measures were investigated utilizing the interaction terms. Results: A total of 2,027 patients with SDB initiated PAP therapy between January 1, 2010 and December 31, 2014. The mean age of the cohort was 56.2 years (standard deviation = 13.2), with 45.8% female and 76.9% Caucasians. EQ-5D change after exclusion of those with normal QoL was 0.042 (0.152) in all patients, 0.051 (0.150) in patients who were PAP adherent by self-report, and 0.050 (0.132) in patients who were objectively PAP adherent (n = 704 of 1,011 with available objective adherence data, 69.6%). Change in FOSQ after excluding those with normal FOSQ was 1.9 (2.9) in all patients, 2.2 (2.9) in patients who were PAP adherent by self-report, and 2.3 (2.9) in patients who were objectively PAP adherent. Those with (1) worse QoL at baseline and younger age and (2) worse QoL at baseline and residing in lower SES strata had worse outcomes after PAP therapy (P < .05). Conclusions:We found consistent improvement in global and sleep-specific QoL measures after PAP therapy, hence providing evidence of PAP benefit in the clinical population and rationale for targeted efforts to optimize QoL in younger and lower SES subgroups. Keywords: age, quality of life, sleep-disordered breathing, socioeconomic status Citation: Walia HK, Thompson NR, Katzan I, Foldvary-Schaefer N, Moul DE, Mehra R. Impact of sleep-disordered breathing treatment on quality of life measures in a large clinic-based cohort.

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Continuous Positive Airway Pressure Improves Quality of Life in Women with Obstructive Sleep Apnea. A Randomized Controlled Trial

Abstract: In women with moderate or severe OSA, 3 months of CPAP therapy improved QoL, mood state, anxiety and depressive symptoms, and daytime sleepiness compared with conservative treatment. Clinical trial registered with www.clinicaltrials.gov (NCT02047071).

Cited by 79 publications

References 45 publications

Determinants of depressive mood in coronary artery disease patients with obstructive sleep apnea and response to continuous positive airway pressure treatment in non‐sleepy and sleepy phenotypes in the RICCADSA cohort

Determinants of depressive mood in coronary artery disease patients with obstructive sleep apnea and response to continuous positive airway pressure treatment in non‐sleepy and sleepy phenotypes in the RICCADSA cohort

Effect of age on the cardiovascular remodelling induced by chronic intermittent hypoxia as a murine model of sleep apnoea

Impact of Sleep-Disordered Breathing Treatment on Quality of Life Measures in a Large Clinic-Based Cohort

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