title: Obstructive sleep apnoea in the elderly: role of continuous positive airway pressure treatment.
abstract: Almost all the information about the effect of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnoea (OSA) comes from clinical trials involving only middle-aged patients. The objective of this study was to assess the effect of CPAP treatment in elderly patients with severe OSA on clinical, quality-of-life and neurocognitive spheres. We performed an open-label, randomised, multicentre clinical trial in a consecutive clinical cohort of 224 elderly (≥70 years old) patients with confirmed severe OSA (apnoea-hypopnea index ≥30) randomised to receive CPAP (n=115) or no CPAP (n=109) for 3 months. A sleep study was performed by either full polysomnography or respiratory polygraphy. CPAP titration was performed by an autoCPAP device. The primary endpoint was quality of life (Quebec Sleep Questionnaire) and secondary endpoints included sleep-related symptoms, presence of anxiety/depression, office-based blood pressure and some neurocognitive tests. The mean±sd age was 75.5±3.9 years. The CPAP group achieved a greater improvement in all quality-of-life domains (p<0.001; effect size: 0.41-0.98), sleep-related symptoms (p<0.001; effect size 0.31-0.91) as well as anxiety (p=0.016; effect size 0.51) and depression (p<0.001; effect size: 0.28) indexes and some neurocognitive tests (digit symbol test (p=0.047; effect size: 0.20) and Trail Making Test A (p=0.029; effect size: 0.44)) in an intention-to-treat analysis. In conclusion, CPAP treatment resulted in an improvement in quality of life, sleep-related symptoms, anxiety and depression indexes and some neurocognitive aspects in elderly people with severe OSA.
authors.affiliation: Respiratory Dept, Hospital Universitario y Politécnico La Fe, Valencia, Spain CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Bunyola, Spain mianmartinezgarcia@gmail.com.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Martínez-García
authors.affiliation: Respiratory Dept, Hospital Universitario San Juan, Alicante, Spain.
authors.forename: Eusebi
authors.initials: E
authors.lastname: Chiner
authors.affiliation: Respiratory Dept, Hospital General Universitario, Alicante, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Hernández
authors.affiliation: Respiratory Dept, Hospital La Plana, Castellón, Spain.
authors.forename: Jose Pascual
authors.initials: JP
authors.lastname: Cortes
authors.affiliation: Respiratory Dept, Hospital General Requena, Valencia, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Catalán
authors.affiliation: Respiratory Dept, Hospital Universitario Peset, Valencia, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Ponce
authors.affiliation: Respiratory Dept, Hospital Universitario, Castellón, Spain.
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Diaz
authors.affiliation: Respiratory Dept, Hospital Torrevieja, Alicante, Spain.
authors.forename: Ester
authors.initials: E
authors.lastname: Pastor
authors.affiliation: Respiratory Dept, Hospital de Sabadell, Corporació Sanitaria Parc Tauli, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Vigil
authors.affiliation: CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Bunyola, Spain Respiratory Dept, Hospital Universitario Virgen del Rocio, Sevilla, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Carmona
authors.affiliation: Respiratory Dept, IDIBAPS-Hospital Clinic, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Montserrat
authors.affiliation: Araba Health Research Unit, BioAraba, Osakidetza, Vitoria, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: Aizpuru
authors.affiliation: Respiratory Dept, Hospital Universitario Vall Hebrón, Barcelona, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Lloberes
authors.affiliation: Respiratory Dept, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Mayos
authors.affiliation: Respiratory Dept, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Selma
authors.affiliation: Respiratory Dept, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Jose Fernando
authors.initials: JF
authors.lastname: Cifuentes
authors.affiliation: Respiratory Dept, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Muñoz
mesh_terms: D000368:Aged; D001007:Anxiety / Q000150:complications; D001794:Blood Pressure; D015992:Body Mass Index; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications; D015331:Cohort Studies; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D003863:Depression / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017286:Polysomnography; D011788:Quality of Life; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D013030:Spain; D011795:Surveys and Questionnaires