Improvement of Mild Sleep-disordered Breathing with CPAP Compared with Conservative Therapy

Abstract

The aim of this randomized controlled trial was to assess the effects of treatment with continuous positive airway pressure versus conservative therapy (CT) on well-being, mood, and functional status in subjects with mild sleep-disordered breathing (SDB). One hundred and eleven subjects, aged 25 to 65 yr, with a respiratory disturbance index (RDI) of 5 to 30 and without subjective pathologic sleepiness, were randomized to nasal CPAP or to CT. Ninety-seven subjects were followed-up after 8 wk. Treatment response was assessed from changes between baseline and follow-up measures of mood, energy/fatigue, and functional status/general health. Of the 51 subjects randomized to CPAP, 25 (49%) experienced an improved outcome, as compared with 12 of 46 of subjects (26%) randomized to CT (p < 0.05). The odds of experiencing a treatment response in the CPAP as compared with the CT group were 2.72 (OR: 1.18 to 6.58, 95% CI). A beneficial effect of CPAP over CT was most evident among individuals without sinus problems and among subjects with hypertension or diabetes. Differential treatment responses were not related to degree of baseline sleepiness or SDB. This suggests that middle-aged snorers with relatively low levels of SDB (RDI < 30) may benefit more from nasal CPAP than from less specific therapy directed at improving breathing during sleep. CPAP therapy may be beneficial to a broader group of subjects than previously appreciated.

Therapy with nCPAP: incomplete elimination of Sleep Related Breathing Disorder

“…These investigators reported that CPAP running time was 66% of the reported sleep-time in continuing users at 28 week follow-up. More recently, other workers observed that patients with mild to moderate degrees of OSA used CPAP for less than half of their total sleep-time [6]. In addition, sleep duration after CPAP initiation was significantly reduced in long sleepers [21].…”

“…It has also been suggested that compliance is better defined by CPAP use in relation to total subjective sleep-time. Using this approach, CPAP was used for 44% up to 68% of time subjects were estimated as being asleep [5,6]. Although good CPAP compliance is frequently defined as usage >5 h .…”

Long-term effects of CPAP on daytime functioning in patients with sleep apnoea syndrome

“…Previous studies investigating the effects of CPAP on neuropsychological performance in SAS, were typically of short duration (weeks) and normally included only a small number of subjects [10±12, 14,15]. With these limitations in mind, the results of these previous studies consistently show that CPAP improves sleepiness, vigilance, mental flexibility, attention, mood, functional status, general health and energy/fatigue in patients with mild, moderate and severe SAS [10±12, 14,15,17]. The results of the present study at 3 months (figs.…”

Obstructive Sleep Apnea: Part Ii. Treatment Modalities.

“…8 The benefit of CPAP in treating the sleepiness associated with OSAHS has been well established. [50][51][52][53][54] The patient's perceived quality of life showed a significant increase after treatment. [51][52][53] Interestingly, the spouses of OSAHS patients also gained from CPAP therapy, as it eliminated the impairment of their own sleep due to the snoring and sleep disruption caused by bed partners.…”