Adherence to CPAP therapy improves quality of life and reduces symptoms among obstructive sleep apnea syndrome patients

Avlonitou, Eirini; Kapsimalis, Fotis; Varouchakis, Georgios; Vardavas, Constantine; Behrakis, Panagiotis

doi:10.1007/s11325-011-0543-8

Cited by 85 publications

(56 citation statements)

References 28 publications

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“…Compliance is at best moderate, and prescription of the device is considered by some patients to be stigmatizing. Even though CPAP use helps improve quality of life, 25 one should not disregard the many reservations patients might have. The positive effects of CPAP cessation, often overlooked, ought to be further investigated.…”

Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea after Weight Loss: A Clinical Trial Comparing Gastric Bypass and Intensive Lifestyle Intervention

Fredheim

Rollheim

Sandbu

et al. 2013

Journal of Clinical Sleep Medicine

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I ntroduction: Few studies have compared the effect of surgical and conservative weight loss strategies on obstructive sleep apnea (OSA). We hypothesized that Roux-en-Y gastric bypass (RYGB) would be more effective than intensive lifestyle intervention (ILI) at reducing the prevalence and severity of OSA (apnea-hypopnea-index [AHI] ≥ 5 events/hour). Methods: A total of 133 morbidly obese subjects (93 females) were treated with either a 1-year ILI-program (n = 59) or RYGB (n = 74) and underwent repeated sleep recordings with a portable somnograph (Embletta). Results: Participants had a mean (SD) age of 44.7(10.8) years, BMI 45.1(5.7) kg/m 2 , and AHI 17.1(21.4) events/hour. Eightyfour patients (63%) had OSA. The average weight loss was 8% in the ILI-group and 30% in the RYGB-group (p < 0.001). The mean (95%CI) AHI reduced in both treatment groups, although signifi cantly more in the RYGB-group (AHI change -6.0 [ILI] vs -13.1 [RYGB]), between group difference 7.2 (1.3, 13.0), p = 0.017. Twenty-nine RYGB-patients (66%) had remission of OSA, compared to 16 ILI-patients (40%), p = 0.028. At follow-up, after adjusting for age, gender, and baseline AHI, the RYGB-patients had signifi cantly lower adjusted odds for OSA than the ILI-patients-OR (95% CI) 0.33 (0.14, 0.81), p = 0.015. After further adjustment for BMI change, treatment group difference was no longer statistically signifi cant-OR (95% CI) 1.31 (0.32, 5.35), p = 0.709. Conclusion: Our study demonstrates that RYGB was more effective than ILI at reducing the prevalence and severity of OSA. However, our analysis also suggests that weight loss, rather than the surgical procedure per se, explains the benefi cial effects. S C I E N T I F I C I N V E S T I G A T I O N SO bstructive sleep apnea (OSA) is a commonly unrecognized condition with an especially high prevalence among morbidly obese subjects.1,2 OSA is characterized by apneas and hypopneas due to the collapse of upper airways and is defi ned by ≥ 5 apneas or hypopneas per hour during sleep, as measured by the apnea-hypopnea index (AHI). Mild OSA is defi ned as 5-15 episodes of apneas or hypopneas per hour, moderate OSA 15-30, and severe OSA ≥ 30. A metaanalysis from 2009 concluded that continuous positive airway pressure (CPAP) is a cost-effective treatment of OSA and that it reduces daytime sleepiness compared to placebo or usual care.3 Accordingly, CPAP is the fi rst-line treatment and is recommended for all patients with moderate to severe OSA (AHI ≥ 15). Obesity, older age, male sex, and heredity are well-established risk factors for OSA, 5 with obesity being the single most important modifi able risk factor. In cases of obesity, fat deposits narrow the upper airways, and abdominal fat masses decrease the tracheal tension, both increasing the collapsibility of the upper airways. If untreated, OSA is associated with increased risk of diabetes, cardiovascular disease, driving accidents, and allcause mortality. BRIEF SUMMARYCurrent Knowledge/Study Rationale: Weight reduction reduces the severity of OSA in ...

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Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea after Weight Loss: A Clinical Trial Comparing Gastric Bypass and Intensive Lifestyle Intervention

Fredheim

Rollheim

Sandbu

et al. 2013

Journal of Clinical Sleep Medicine

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“…A eficácia do uso do CPAP vai depender da tolerância por parte do indivíduo, fatores como a adequação e o conforto da máscara associados ao ajuste ideal da pressão do aparelho são essenciais para o sucesso do tratamento (MEKHITARIAN NETO, 2009;AVLONITOU et al, 2012).…”

Section: Introductionunclassified

Qualidade de vida (QV) e aspectos clínicos de pacientes com síndrome da apneia obstrutiva do sono (SAOS) em tratamento com pressão positiva contínua nas vias aéreas (CPAP)

Lacerda¹,

Cunha²,

Souza³

et al. 2013

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“…1,[4][5][6][7][8] Regular use of PAP reduces the frequency of respiratory disturbances and hypoxemia, and improves overall sleep quality. 9 PAP compliance is typically defi ned as a minimum of 4 hours of use per night for at least 70% of the nights, [9][10][11] although some studies indicate that the use of PAP for 6 or more hours per night may be more clearly associated with improvement in sleepiness, daily functioning, and memory. 12 PAP devices commonly incorporate software that measures and records adherence data such as the number of days and duration that the PAP device is used as well as its effi cacy, allowing for more accurate assessment of success with treatment.…”

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confidence: 99%

“…The impact of OSAS and its treatment has been extensively investigated with regard to motor vehicle accidents, medical risks, and academic performance in children. 2,3,9,17 Surprisingly, a relative paucity of data has been published regarding the impact of this condition on athletic and recreational performance.…”

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confidence: 99%

Treatment of Obstructive Sleep Apnea Syndrome with Nasal Positive Airway Pressure Improves Golf Performance

Benton

Friedman

2013

Journal of Clinical Sleep Medicine

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Adherence to CPAP therapy improves quality of life and reduces symptoms among obstructive sleep apnea syndrome patients

Abstract: We conclude that OSAS patients who adhere to nighttime CPAP therapy show significant improvement of their quality of life, daytime sleepiness, and other symptoms after 6 months of treatment with CPAP.

Cited by 85 publications

References 28 publications

Obstructive Sleep Apnea after Weight Loss: A Clinical Trial Comparing Gastric Bypass and Intensive Lifestyle Intervention

Obstructive Sleep Apnea after Weight Loss: A Clinical Trial Comparing Gastric Bypass and Intensive Lifestyle Intervention

Qualidade de vida (QV) e aspectos clínicos de pacientes com síndrome da apneia obstrutiva do sono (SAOS) em tratamento com pressão positiva contínua nas vias aéreas (CPAP)

Treatment of Obstructive Sleep Apnea Syndrome with Nasal Positive Airway Pressure Improves Golf Performance

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