Relationship Between Hours of CPAP Use and Achieving Normal Levels of Sleepiness and Daily Functioning

Weaver, Terri E.; Maislin, Greg; Dinges, David F.; Bloxham, Thomas J; George, Charles F.; Greenberg, Harly; Kader, G.; Mahowald, Mark; Younger, Joel; Pack, Allan I.

doi:10.1093/sleep/30.6.711

Cited by 872 publications

(682 citation statements)

References 36 publications

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“…60 Patients whose ES was resolved during treatment (ie, their ESS score reduced to < 10) used CPAP for approximately 1 hour more each night than study participants who reported experiencing residual ES (5.1 versus 4.0 hours of CPAP use per night, respectively). 60 Patients with higher depression scores have been reported to have lower compliance with CPAP, 61 and the interventions discussed below may be of particular use in this patient population as an aid to compliance.…”

Section: Confirmation Of Initial Diagnosismentioning

confidence: 90%

“…Even with optimal CPAP therapy, up to half of patients with OSA have residual ES. 60 In patients compliant with CPAP therapy but who still experience ES, adjunctive pharmacologic therapy is a treatment option. Before introducing such therapy, it is important to ensure that CPAP is being used appropriately by checking the air pressure of the device and the level of patient compliance.…”

Section: Evaluation and Treatment Of Residual Esmentioning

confidence: 99%

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Recognizing and Managing Obstructive Sleep Apnea in Primary Care

Culpepper¹,

Roth²

2009

Prim. Care Companion J. Clin. Psychiatry

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Objective: This review aims to impart information regarding recognition of obstructive sleep apnea (OSA) and associated excessive sleepiness (ES) in the primary care setting in order to provide optimal care to patients with this common but serious condition. This review will also discuss the prevalence and treatment of depression in patients with OSA.Data Sources: A MEDLINE search of articles published between 1990 and 2008 was conducted using the search terms obstructive sleep apnea AND excessive sleepiness, obstructive sleep apnea AND depression, and obstructive sleep apnea AND primary care. Searches were limited to articles in English concerned with adult patients.Study Selection: In total, 239 articles were identified. Articles concerning other sleep disorders and forms of apnea were excluded. The reference lists of identified articles were searched manually to find additional articles of interest.Data Synthesis: Primary care physicians can aid in the diagnosis of OSA and associated ES by being vigilant for lifestyle and physical risk factors associated with this condition. In addition, primary care physicians should maintain a high level of clinical suspicion when presented with illnesses that are commonly comorbid with OSA, such as psychiatric disorders and depression, in particular. Conversely, assessment of patients with OSA for common comorbidities may also improve a patient's prognosis and quality of life.Conclusions: Primary care physicians play a vital role in recognizing OSA and ES. These clinicians are crucial in supporting their patients during treatment by ensuring that they have clear, concise information regarding available therapies and the correct application and maintenance of prescribed devices.

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Section: Confirmation Of Initial Diagnosismentioning

confidence: 90%

Section: Evaluation and Treatment Of Residual Esmentioning

confidence: 99%

Recognizing and Managing Obstructive Sleep Apnea in Primary Care

Culpepper¹,

Roth²

2009

Prim. Care Companion J. Clin. Psychiatry

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“…Our tetraplegic population scored significantly worse than the normal sample in the activity level and intimate and sexual activity domains, but there was no difference in the total score and other three domains (Table 3). 12,13 Basic Nordic Sleep Questionnaire The BNSQ was completed by 163 participants. Tables showing the entire Table 1).…”

Section: Assessment Of Quality Of Lifementioning

confidence: 99%

Subjective sleep disturbances and quality of life in chronic tetraplegia

et al. 2015

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Study design: This is a cross-sectional survey. Objectives: The objective of this study was to evaluate the subjective sleep disturbances and quality of life in chronic tetraplegia. Setting: This study was conducted in a community sample from Victoria, Australia. Methods: People with tetraplegia were mailed a survey battery including the following: demographic questions; Karolinska Sleepiness Scale (KSS); Basic Nordic Sleepiness Questionnaire; Functional Outcomes of Sleep Questionnaire (FOSQ); Multivariate Apnoea Prediction Index and Assessment of Quality of Life (AQoL) Questionnaire. Scores were compared with the best available normative data. Results: A total of 163 of 424 (38%) surveys were returned (77% male; 39% sensory and motor complete; mean age±s.d. = 46±14 years; mean years since injury = 11±8 years). The AQoL health utility score (0.31±0.29) was significantly lower than published population norms. FOSQ total (17.55±2.57) and KSS (3.93±2.27) scores were no different from the best available population data. People with tetraplegia reported worse sleep habits, symptoms and quality than a normal population, as indicated on 17 of 21 questions on the Basic Nordic Sleep Questionnaire. Multivariate analysis found that greater injury severity (coefficient (95% CI) = 0.14 (0.10, 0.18)), increasing age (−0.004 (−0.008, − 0.001)) and worse sleep symptoms (−0.005 (−0.009, − 0.0003)) were all significantly associated with reduced quality of life. Conclusion: People with chronic tetraplegia experience more subjective sleep problems and worse quality of life than their able-bodied counterparts. Quality of life is related to injury severity, age and sleep symptoms. Treating the sleep disorders experienced by people living with tetraplegia has the potential to improve their health and well-being.

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“…Continuous positive airway pressure (CPAP) device is currently considered to be the first-line treatment for OSA in adults [3]. When used properly, CPAP treatment is efficacious at reducing both subjective symptoms of OSA and cardiovascular risk [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…However, CPAP efficacy is limited by highly variable patient compliance to therapy. In the literature, the reported adherence to CPAP ranges from 30 to 70 % [3,6]. Thus, a significant number of patients ultimately abandon CPAP therapy.…”

Section: Introductionmentioning

confidence: 99%

Surgical Therapy of Obstructive Sleep Apnea: A Review

2012

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Obstructive sleep apnea (OSA) is a disease characterized by intermittent and repetitive narrowing of the airway during sleep. Surgical therapies for the treatment of OSA aim to improve airway patency by addressing selected site(s) of obstruction. Because several areas may each be responsible for the narrowing, different surgical modalities have also been developed. In this review, we give an overview of surgery for each of potential obstruction site(s). As a consequence of the multi-factorial and heterogeneous etiology of OSA, surgical therapies need to be selected and performed specifically for each patient, as there is no perfect surgery that will fit all patients. As with any other treatment modalities for OSA, surgical therapies have variable efficacy, but are a very important tool on OSA management in selected patients and have been shown effectiveness in decreasing the morbidity and mortality associated with the disease.

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Relationship Between Hours of CPAP Use and Achieving Normal Levels of Sleepiness and Daily Functioning

Abstract: Our analyses suggest that a greater percentage of patients will achieve normal functioning with longer nightly CPAP durations, but what constitutes adequate use varies between different outcomes.

Cited by 872 publications

References 36 publications

Recognizing and Managing Obstructive Sleep Apnea in Primary Care

Recognizing and Managing Obstructive Sleep Apnea in Primary Care

Subjective sleep disturbances and quality of life in chronic tetraplegia

Surgical Therapy of Obstructive Sleep Apnea: A Review

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