title: Immediate effect of CPAP titration on perceived health related quality of life: a prospective observational study.
abstract: Perceived Health Related Quality of Life (HRQoL) is impaired in obstructive sleep apnea (OSA). This study examines changes in HRQoL aspects occurring immediately after CPAP titration. Furthermore, we analyzed variations in each gender and in patients undergoing home or laboratory-based CPAP titration pathways.
  
  
  
  Twohundredfive outpatients (151 M) (56.7 ± 10.3 years) were evaluated, before first visit and nocturnal diagnostic examination (T0), and the morning after CPAP titration (T1). Two self-reported HRQoL questionnaires were administered: Psychological General Well-Being Index (PGWBI), composed by six subscales, and 12-Item Short-Form Health Survey (SF-12), including Physical (PCS) and Mental Component Summaries (MCS). CPAP titration was performed using auto-adjusting CPAP units at patients' home or in the sleep laboratory.
  
  
  
  PGWBI scores at T1 improved compared to T0 (p < 0.0001). A similar improvement was observed in SF-12 MCS (p = 0.0011), but not in SF-12 PCS. Changes were independent from anthropometric parameters, OSA severity and excessive daytime sleepiness. Gender comparisons showed better HRQoL in males at both times. At T0, patients who received home or laboratory CPAP titration pathways did not show any differences in PGWBI and SF-12 scores. At T1, PGWBI and SF-12 MCS improved in both home and laboratory groups.
  
  
  
  This study gives evidence that first time CPAP application for titration can lead to a general increase in perceived well-being. Gender comparisons showed better perceived HRQoL with more subscales improvements in males after CPAP titration. The improvement was similar with both home and laboratory CPAP titration pathways.
authors.affiliation: National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Iacono Isidoro
authors.affiliation: National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy. salvaggio@ibim.cnr.it.
authors.forename: Adriana
authors.initials: A
authors.lastname: Salvaggio
authors.affiliation: National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Lo Bue
authors.affiliation: National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Romano
authors.affiliation: National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy.
authors.forename: Oreste
authors.initials: O
authors.lastname: Marrone
authors.affiliation: National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Via Ugo La Malfa, 153, Palermo, 90146, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Insalaco
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D045422:Continuous Positive Airway Pressure; D003863:Depression / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000523:psychology* / Q000628:therapy*
keywords: CPAP titration; Gender; Obstructive sleep apnea; Quality of Life