title: Continuous positive airway pressure treatment of sleepy patients with milder obstructive sleep apnea: results of the CPAP Apnea Trial North American Program (CATNAP) randomized clinical trial.
abstract: BACKGROUND
  Twenty-eight percent of people with mild to moderate obstructive sleep apnea experience daytime sleepiness, which interferes with daily functioning. It remains unclear whether treatment with continuous positive airway pressure improves daytime function in these patients.
  
  
  OBJECTIVE
  To evaluate the efficacy of continuous positive airway pressure treatment to improve functional status in sleepy patients with mild and moderate obstructive sleep apnea.
  
  
  METHODS
  Patients with self-reported daytime sleepiness (Epworth Sleepiness Scale score >10) and an apnea-hypopnea index with 3% desaturation and from 5 to 30 events per hour were randomized to 8 weeks of active or sham continuous positive airway pressure treatment. After the 8-week intervention, participants in the sham arm received 8 weeks of active continuous positive airway pressure treatment.
  
  
  RESULTS
  The Total score on the Functional Outcomes of Sleep Questionnaire was the primary outcome measure. The adjusted mean change in the Total score after the first 8-week intervention was 0.89 for the active group (n = 113) and -0.06 for the placebo group (n = 110) (P = 0.006). The group difference in mean change corresponded to an effect size of 0.41 (95% confidence interval, 0.14-0.67). The mean (SD) improvement in Functional Outcomes of Sleep Questionnaire Total score from the beginning to the end of the crossover phase (n = 91) was 1.73 ± 2.50 (t[90] = 6.59; P < 0.00001) with an effect size of 0.69.
  
  
  CONCLUSIONS
  Continuous positive airway pressure treatment improves the functional outcome of sleepy patients with mild and moderate obstructive sleep apnea.
authors: University of Illinois at Chicago College of Nursing, 845 South Damen Avenue (MC 802), Chicago, IL 60612, USA. teweaver@uic.edu
authors: Terri E
authors: TE
authors: Weaver
authors: Cristina
authors: C
authors: Mancini
authors: Greg
authors: G
authors: Maislin
authors: Jacqueline
authors: J
authors: Cater
authors: Bethany
authors: B
authors: Staley
authors: J Richard
authors: JR
authors: Landis
authors: Kathleen A
authors: KA
authors: Ferguson
authors: Charles F P
authors: CF
authors: George
authors: David A
authors: DA
authors: Schulman
authors: Harly
authors: H
authors: Greenberg
authors: David M
authors: DM
authors: Rapoport
authors: Joyce A
authors: JA
authors: Walsleben
authors: Teofilo
authors: T
authors: Lee-Chiong
authors: Indira
authors: I
authors: Gurubhagavatula
authors: Samuel T
authors: ST
authors: Kuna
mesh_terms: D000328:Adult; D000339:Affect; D001794:Blood Pressure; D015331:Cohort Studies; D045422:Continuous Positive Airway Pressure; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D057566:Self Report; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012894:Sleep Stages; D016896:Treatment Outcome