A comparison of the long-term outcome and effects of surgery or continuous positive airway pressure on patients with obstructive sleep apnea syndrome.
OBJECTIVE
To compare the long-term (3-year) outcome and effects of continuous positive airway pressure (CPAP) and extended uvulopalatoplasty (EUPF) treatment on patients with obstructive sleep apnea syndrome.


METHODS
Eighty-four patients who received CPAP titration and bought a CPAP machine to use from March 2000 to October 2001 were included as the CPAP group. Another 55 patients who underwent EUPF surgery were included as the EUPF group. Overnight polysomnography was performed 6 months and 3 years after CPAP titration or EUPF. The disease-specific questionnaire-Snore Outcome Survey (SOS), Epworth Sleepiness Scale (ESS), and the generic health questionnaire-MOSF-36 were administered at the 6-month and 3-year follow-up examinations.


RESULTS
The age, body mass index, respiratory disturbance index, and ESS before treatment were higher in the CPAP group. The snore index was higher in the surgery group. Fifty-four patients (64.3%) in CPAP group continued treatment for 6 months; the success rate for EUPF at 6 months was 82%. The polysomnographic variables improved significantly in both groups. Improvements in the SOS and ESS scores were better in surgery group than the CPAP group. The subscales of SF-36 in surgery group were more than those in CPAP group.


CONCLUSIONS
EUPF had a better effect on snoring than CPAP 6 months after treatment in patients with obstructive sleep apnea syndrome (OSAS). This effect had gradually declined at the 3-year follow-up examination. Improvement in the quality of life of OSAS patients receiving EUPF is equal to those receiving CPAP treatment.
Lin
Shih-Wei
SW
Department of Pulmonary and Critical Care Medicine, Sleep Center, Chang-Gung Memorial Hospital, Chang Gung Institute of Technology, Chang Gung University, Taipei, Taiwan.
Chen
Ning-Hung
NH
Li
Hsueh-Yu
HY
Fang
Tuan-Jen
TJ
Huang
Chong-Chi
CC
Tsai
Yiang-Huang
YH
Lee
Cheng-Huei
CH
D045422:Continuous Positive Airway Pressure; D006801:Humans; D008875:Middle Aged; D010160:Palate, Soft / Q000601:surgery; D017286:Polysomnography; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000601:surgery / Q000628:therapy*; D012913:Snoring / Q000503:physiopathology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery