Quality of Life in Moderate-Severe OSA Patients from North-Eastern Romania

Abstract

Obstructive sleep apnea (OSA) is the most common type of sleep disordered breathing, with a signifi cant impact on health-related quality of life (HR-QoL). Continuous positive airway pressure (CPAP) is the gold-standard treatment for moderate-severe OSA, but is associated with poor patient compliance (due to fi nancial issues and frequent side eff ects). The purpose of this study is to evaluate HR-QoL among patients with moderate-severe OSA from NorthEastern Romania, at baseline and after 2 months of CPAP. 75 patients were initially included in our study but only 59 subjects returned for a second evaluation. HR-QoL was assessed using the European Quality of Life 5 Domain questionnaire (EQ-5D-5L). OSA has a signifi cant impact on quality of life in our group, with an average EQ-5D-5L index of 0.70±0.27 and an EQ-5D-5L Visual Analogue Scale (VAS) of 63.71±17.74%. Short-term CPAP use was associated with a statistically signifi cant improvement in Epworth Sleepiness Scale (Δ = 4.44, p <0.0000001), EQ-5D-5L index (Δ = 0.1, p=0.0008) and EQ-5D-5L VAS (Δ = 9.38%, p=0.00002). All patients with a high income (> 4000 lei/month) decided to continue using the device, while the decision not to continue CPAP was signifi cantly more frequent among patients with a low income (< 1000 lei /month-52.63% versus 21.21%, p=0.01). Our results suggest that income level signifi cantly infl uences CPAP compliance.

Long-Term Adherence in Overweight Patients with Obstructive Sleep Apnea and Hypertension—A Pilot Prospective Cohort Study

“…PAP cost is not covered by the Romanian public health care system and is high when compared to the country’s average income. However, other factors, especially inadequate device pressure, mask-related discomfort, stigma and shame, significantly diminish PAP adherence [ 33 ]. The economical factor could explain why AHI, age, BMI and quality of life were not significant predictors for long-term PAP adherence in our study.…”

“…All patients were educated regarding the importance of a healthy lifestyle (nutrition and physical activity) and the need of daily PAP use and received free PAP therapy for 2 months (DreamStation Auto CPAP–Philips Respironics, REMstar Auto C-Flex CPAP–Philips Respironics or AirSense 10 AutoSet CPAP–ResMed). Data regarding our cohort, study protocol and preliminary (2 month) results have been previously published [ 33 , 34 , 35 , 36 , 37 ].…”

EQ-5D-5L: a value set for Romania

“…So far, in Romania, the EQ-5D-5L has been used in studies conducted in clinical populations, such as patients with HIV [ 8 ], obstructive sleep apnoea [ 9 ], cancer [ 10 ] or hepatitis C [ 11 ]. Nevertheless, the preferred instrument to generate QALYs in Romania is the EQ-5D, just like in many other countries [ 12 ].…”