Can continuous positive airway pressure therapy improve the general health status of patients with obstructive sleep apnea?: a clinical effectiveness study.
OBJECTIVE
To determine the short-term and long-term impacts of continuous positive airway pressure (CPAP) therapy on health-related quality of life (HRQL) in patients with obstructive sleep apnea (OSA).


METHODS
Prospective longitudinal cohort study.


METHODS
University sleep disorders center.


METHODS
Three hundred sixty-five patients with an apnea-hypopnea index (AHI) > or = 20 per hour of sleep and 358 patients with an AHI of < 20.


METHODS
All patients with AHIs > or = 20 received CPAP therapy; those with AHIs < 20 did not. The HRQL of all study participants was measured using the 36-item medical outcomes study short form (SF-36) questionnaire at baseline and then at 3 and 12 months of follow-up.


RESULTS
Although the SF-36 scores were similar at baseline, after 3 months of therapy, the CPAP group had higher adjusted emotional summary scores than did those who did not receive CPAP therapy (score increase, 1.72; 95% confidence interval [CI], 0.08 to 3.37). These improvements were maintained for 12 months. The gains in the SF-36 scores were most striking in the vitality domain (score increase, 10.52; 95% CI, 7.04 to 14.00 U increment). The severe OSA group (ie, AHIs > or = 40) experienced the largest benefit. Their adjusted vitality scores were 12.3 U higher (95% CI, 8.0 to 16.6) than those persons without OSA (ie, AHIs < 5).


CONCLUSIONS
CPAP therapy was associated with marked short-term and long-term improvements in the vitality of patients with moderate-to-severe OSA in the community. These findings suggest that CPAP therapy is effective in improving the long-term HRQL of patients with OSA.
Sin
Don D
DD
Departments of Pulmonary Medicine, University of Alberta, Edmonton, AB, Canada. don.sin@ualberta.ca
Mayers
Irvin
I
Man
Godfrey C W
GC
Ghahary
Ali
A
Pawluk
Lawrence
L
D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D013997:Time Factors