Continuous Positive Airway Pressure Adherence and Treatment Cost in Patients With Obstructive Sleep Apnea and Cardiovascular Disease

Bock, Joshua M.; Needham, Keith; Gregory, David A.; Ekono, Mercedes M; Wickwire, Emerson M.; Somers, Virend K.; Lerman, Amir

doi:10.1016/j.mayocpiqo.2022.01.002

Cited by 19 publications

(14 citation statements)

References 41 publications

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“…Moreover, productivity, workplace incidents, car accidents, and comorbidities increase the estimated costs. Joshua M. Bock et al concluded that the annual care cost of adherent CPAP patients with cardiovascular comorbidities was lower than those of the non-adherent group (USD 6825, USD 11,312; p < 0.05), and health care investment was reduced by 40% in 1 year [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

CPAP Therapy on Depressive and Anxiety Symptoms in Patients with Moderate to Severe Obstructive Sleep Apnea Syndrome

et al. 2022

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Backgrounds and Objectives: There is a link between sleep apnea syndrome (OSA) and depressive and anxiety symptoms, but the underlying mechanisms are not fully understood. The study aimed to determine the prevalence of these symptoms in patients with OSA and to evaluate the impact of continuous positive airway pressure (CPAP) on depression and anxiety scores. Materials and Methods: Ninety-nine consecutive new patients diagnosed with moderate or severe (apnea-hypopnea index AHI ≥ 15 events/h) OSA were accepted for the CPAP therapy. Patients completed a patient health questionnaire (PHQ-9) for depressive symptoms and a generalized anxiety questionnaire (GAD-7) for anxiety symptoms before the CPAP treatment, after 6 months, and after 1 year of CPAP therapy with compliance. For both scores (PHQ-9 and GAD-7), a cut point ≥10 was used to indicate the presence of clinically depressive and anxiety symptoms. Results: Forty-eight individuals (48.48%) had PHQ-9 scores above the cut-off point ≥ 10, and twenty-seven participants (27.27%) had GAD-7 scores above the cut-off point ≥10. A significant correlation has been shown between PHQ-9 score and BMI (p < 0.0001), AHI (p < 0.0001), ODI (p < 0.001), ESS (p < 0.001), GAD-7 score (p < 0.0001), and [t90] (p < 0.0001), while GAD-7 was correlated with AHI (p < 0.030), ODI (p < 0.006), and [t90] (p < 0.001). The PHQ-9 and GAD-7 scores decreased significantly after 6 months of CPAP therapy in all groups and after 1 year of CPAP use. Conclusions: OSA patients should be screened for depression and anxiety. Furthermore, CPAP should be the first choice of treatment before starting other treatments for depression and anxiety symptoms.

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Section: Discussionmentioning

confidence: 99%

CPAP Therapy on Depressive and Anxiety Symptoms in Patients with Moderate to Severe Obstructive Sleep Apnea Syndrome

et al. 2022

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“…For example, Joshua M. Bock et al found that the annual care cost of adherent CPAP patients with cardiovascular comorbidities was lower than those of the non-adherent group ($6825, $11,312; p < 0.05). The healthcare investment was reduced by 40% in one year [ 42 ]. Data from the literature showed that mandibular advancement devices are an economical alternative treatment to evaluate responder or nonresponder OSA patients [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of CPAP Therapy Adherence on Global Cognition in Patients with Moderate to Severe Obstructive Sleep Apnea: A One-Year Follow-Up

et al. 2023

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Background: Obstructive sleep apnea increases (OSA) cognitive impairment risk. The objective of this study was to determine the impact of continuous positive airway pressure (CPAP) adherence on global cognition using the Montreal Cognitive Assessment questionnaire (MoCA). Materials and Methods: Thirty-four new patients diagnosed with moderate or severe OSA (apnea-hypopnea index AHI ≥ 15 events/h) from the CPAP group were compared with thirty-one moderate to severe OSA patients from the no-CPAP group. In addition, all patients completed the MoCA test, a patient health questionnaire (PHQ-9) for depressive symptoms, and a generalized anxiety questionnaire (GAD-7) for anxiety symptoms, at baseline, after 6 months, and after 1 year. Results: At baseline, there were no significant differences between the two groups regarding total MoCA scores, 20.9 ± 3.5 CPAP group to 19.7 ± 2.9 no-CPAP group (p = 0.159), PHQ-9 (p = 0.651), and GAD-7 (p = 0.691). After one year, improvement was observed for a total MoCA score of 22.7 ± 3.5 (p < 0.001) for the CPAP group, and significant variance of score between groups was more accentuated for delayed recall and attention (p < 0.001) sub-topic. Moreover, PHQ-9, GAD-7 scores, and the Epworth Sleepiness Scale (ESS) decreased significantly (p < 0.001) after CPAP therapy. The MoCA score was significantly correlated with years of education (r = 0.74, p < 0.001) and had a negative correlation with body mass index (BMI) (r = −0.34), ESS (r = −0.30) and PHQ-9 (r = −0.34). Conclusions: One year of CPAP adherence improved global cognition associated with OSA.

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“…The well-documented complications of hypertension and cardiovascular disease in patients with OSAS emphasizes the importance of timely intervention [1,3]. Therapeutic interventions, including the use of continuous positive airway pressure (CPAP), are crucial for managing OSAS, with CPAP being a non-invasive and easily implementable option [4,5]. However, the initial stages of CPAP therapy can pose challenges for patients due to the adjustment process [4].…”

Section: Introductionmentioning

confidence: 99%

“…Therapeutic interventions, including the use of continuous positive airway pressure (CPAP), are crucial for managing OSAS, with CPAP being a non-invasive and easily implementable option [4,5]. However, the initial stages of CPAP therapy can pose challenges for patients due to the adjustment process [4].…”

Section: Introductionmentioning

confidence: 99%

Management of Refractory Hypertension in a Patient with Untreated Sleep Apnea Syndrome Using Continuous Positive Airway Pressure Therapy

Hamamoto,

Yano,

Zou

et al. 2024

JCR

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Background: Sleep apnea syndrome (SAS) is a common sleep disorder characterized by recurrent episodes of upper airway obstruction during sleep, leading to disrupted sleep patterns and oxygen desaturation. SAS can have significant implications for cardiovascular health, with hypertension being a common co-morbidity. Despite its prevalence and associated risks, SAS often remains undiagnosed and untreated for many years, contributing to worsening cardiovascular outcomes. Case Report: This case report presents the clinical course of a patient initially diagnosed with severe SAS with an Apnea-Hypopnea Index (AHI) of 34 at the age of 30, the patient remained untreated for approximately two decades. Following a recent medical checkup in 2022, the patient was diagnosed with hypertension and referred to the hospital. Despite oral administration of antihypertensive drugs for less than a year, no significant improvement in blood pressure was observed. Due to persistent symptoms such as daytime sleepiness and early morning headaches, along with a history of SAS, Continuous Positive Airway Pressure (CPAP) therapy was initiated. Conclusion: Detailed blood pressure recordings over the preceding months demonstrated a statistically significant improvement, highlighting the efficacy of CPAP therapy in managing refractory hypertension in patients with SAS. Enhanced compliance with CPAP therapy can be facilitated through regular blood pressure monitoring, ultimately improving clinical outcomes and quality of life in this patient population.

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Continuous Positive Airway Pressure Adherence and Treatment Cost in Patients With Obstructive Sleep Apnea and Cardiovascular Disease

Cited by 19 publications

References 41 publications

CPAP Therapy on Depressive and Anxiety Symptoms in Patients with Moderate to Severe Obstructive Sleep Apnea Syndrome

CPAP Therapy on Depressive and Anxiety Symptoms in Patients with Moderate to Severe Obstructive Sleep Apnea Syndrome

Impact of CPAP Therapy Adherence on Global Cognition in Patients with Moderate to Severe Obstructive Sleep Apnea: A One-Year Follow-Up

Management of Refractory Hypertension in a Patient with Untreated Sleep Apnea Syndrome Using Continuous Positive Airway Pressure Therapy

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