title: Continuous Positive Airway Pressure Improves Quality of Life in Women with Obstructive Sleep Apnea. A Randomized Controlled Trial.
abstract: Continuous positive airway pressure (CPAP) is the treatment of choice in patients with symptomatic obstructive sleep apnea (OSA). CPAP treatment improves quality of life (QoL) in men with OSA, but its role in women has not yet been assessed.
  
  
  
  To investigate the effect of CPAP on QoL in women with moderate to severe OSA.
  
  
  
  We conducted a multicenter, open-label randomized controlled trial in 307 consecutive women diagnosed with moderate to severe OSA (apnea-hypopnea index, ≥15) in 19 Spanish sleep units. Women were randomized to receive effective CPAP therapy (n = 151) or conservative treatment (n = 156) for 3 months. The primary endpoint was the change in QoL based on the Quebec Sleep Questionnaire. Secondary endpoints included changes in daytime sleepiness, mood state, anxiety, and depression. Data were analyzed on an intention-to-treat basis with adjustment for baseline values and other relevant clinical variables.
  
  
  
  The women in the study had a mean (SD) age of 57.1 (10.1) years and a mean (SD) Epworth Sleepiness Scale score of 9.8 (4.4), and 77.5% were postmenopausal. Compared with the control group, the CPAP group achieved a significantly greater improvement in all QoL domains of the Quebec Sleep Questionnaire (adjusted treatment effect between 0.53 and 1.33; P < 0.001 for all domains), daytime sleepiness (-2.92; P < 0.001), mood state (-4.24; P  = 0.012), anxiety (-0.89; P = 0.014), depression (-0.85; P = 0.016), and the physical component summary of the 12-item Short Form Health Survey (2.78; P = 0.003).
  
  
  
  In women with moderate or severe OSA, 3 months of CPAP therapy improved QoL, mood state, anxiety and depressive symptoms, and daytime sleepiness compared with conservative treatment. Clinical trial registered with www.clinicaltrials.gov (NCT02047071).
authors.affiliation: 1 Respiratory Department, Hospital Universitario de Valme, Sevilla, Spain.
authors.forename: Francisco
authors.identifier: 0000-0002-2632-3073
authors.initials: F
authors.lastname: Campos-Rodriguez
authors.affiliation: 2 Respiratory Department, Hospital Universitario Marques de Valdecilla, Santander, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Queipo-Corona
authors.affiliation: 3 Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocio University Hospital, Sevilla, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Carmona-Bernal
authors.affiliation: 4 Department of Respiratory Medicine, Reina Sofia University Hospital, Institute of Biomedical Research Maimonides (IMIBIC), University of Cordoba, Cordoba, Spain.
authors.forename: Bernabe
authors.initials: B
authors.lastname: Jurado-Gamez
authors.affiliation: 5 Gerencia de Atención Primaria de Burgos, Burgos, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Cordero-Guevara
authors.affiliation: 1 Respiratory Department, Hospital Universitario de Valme, Sevilla, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Reyes-Nuñez
authors.affiliation: 6 Respiratory Department, Fundación Jimenez Diaz, Madrid, Spain.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Troncoso-Acevedo
authors.affiliation: 7 Respiratory Department, Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: Araceli
authors.initials: A
authors.lastname: Abad-Fernandez
authors.affiliation: 8 Respiratory Department, Hospital Universitario de Burgos, Burgos, Spain.|9 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Teran-Santos
authors.affiliation: 10 Respiratory Department, Hospital Morales Meseguer, Murcia, Spain.
authors.forename: Julian
authors.initials: J
authors.lastname: Caballero-Rodriguez
authors.affiliation: 11 Respiratory Department, Hospital Universitario Virgen de la Victoria, Malaga, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Martin-Romero
authors.affiliation: 12 Respiratory Department, Hospital Severo Ochoa, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Encabo-Motiño
authors.affiliation: 13 Respiratory Department, Hospital General de Tomelloso, Ciudad Real, Spain.
authors.forename: Lirios
authors.initials: L
authors.lastname: Sacristan-Bou
authors.affiliation: 14 Respiratory Department, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Navarro-Esteva
authors.affiliation: 15 Respiratory Department, Consorcio Sanitario de Terrassa, Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Somoza-Gonzalez
authors.affiliation: 9 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.|16 Respiratory Department, Hospital San Pedro de Alcantara, Caceres, Spain.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Masa
authors.affiliation: 17 Respiratory Department, Hospital Virgen del Puerto, Caceres, Spain.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Sanchez-Quiroga
authors.affiliation: 18 Respiratory Department, Hospital Puerta de Hierro, Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Jara-Chinarro
authors.affiliation: 19 Respiratory Department, Hospital Universitario Doctor Peset, Valencia, Spain; and.
authors.forename: Belen
authors.initials: B
authors.lastname: Orosa-Bertol
authors.affiliation: 9 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.|20 Respiratory Department, Hospital Universitario y Politecnico La Fe, Valencia, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martinez-Garcia
mesh_terms: D000339:Affect; D001007:Anxiety / Q000517:prevention & control / Q000523:psychology; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D003863:Depression / Q000517:prevention & control / Q000523:psychology; D006970:Disorders of Excessive Somnolence / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D020181:Sleep Apnea, Obstructive / Q000523:psychology* / Q000628:therapy*; D013030:Spain; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Quebec Sleep Questionnaire; continuous positive airway pressure; obstructive sleep apnea; quality of life; women