CPAP therapy in patients with idiopathic pulmonary fibrosis and obstructive sleep apnea: does it offer a better quality of life and sleep?

Abstract

Effective CPAP treatment in IPF patients with OSA results in a significant improvement in daily living activities based on the FOSQ, namely an OSA-specific follow-up instrument. Improvement was also noted in other questionnaires assessing quality of life, though not to a statistically significant degree, probably because of the multifactorial influences of IPF on physical and mental health. The probability of poor CPAP compliance was high and could only be eliminated with intense follow-up by the CPAP clinic staff.

The clinical effectiveness and cost-effectiveness of treatments for idiopathic pulmonary fibrosis: a systematic review and economic evaluation

“…Nine studies 61,[109][110][111][112][113][114][115][116] assessed HRQoL using the SF-36, seven used the SGRQ, 55,73,[117][118][119][120][121][122] five studies used both the SF-36 and SGRQ [123][124][125][126][127] and two studies used the SF-36, the SGRQ and the EQ-5D 68,72 (Table 65). Two studies used the EQ-5D.…”

“…Two other multicentre studies were US-based only. 68,72 The remaining studies were single-centre studies from countries such as Japan (six studies 73,[112][113][114][115]122 ), Brazil (three studies 109,111,124 ), Poland (three studies 61,112,127 ), Turkey (one study 110 ), Canada (one study 123 ), the Netherlands (one study China (one study 118 ), Greece (two studies 116,120 ) and the USA (one study 55 ). Generalisability of these populations to those seen in current UK practice may, therefore, be limited.…”

“…Study designs varied. Six studies 55,68,72,73,125,126 were based on five RCTs of interventions where HRQoL was an outcome measure, one was a CCT, 61 and four studies were cohort 'before-and-after' studies that tested HRQoL at baseline and then again after an intervention; 110,113,114,116 one of these also had a control group of patients with COPD. 114 Five studies 111,119,[122][123][124] were single-cohort studies with no intervention, three 112,115,118 were single-cohort studies that collected HRQoL data at two different time points (one also had an additional control group 112 ), two studies 109,120 were cohort studies with matched controls, one was a cohort study with subgroup data 127 and one 117 was a combination of a focus group and survey.…”

“…114 Five studies 111,119,[122][123][124] were single-cohort studies with no intervention, three 112,115,118 were single-cohort studies that collected HRQoL data at two different time points (one also had an additional control group 112 ), two studies 109,120 were cohort studies with matched controls, one was a cohort study with subgroup data 127 and one 117 was a combination of a focus group and survey. Seven of the 16 studies using the SF-36 did not report the overall physical or mental health summary scores, [109][110][111]113,114,124,125 one study reported only the overall summary scores (at baseline), 68 one study reported only an overall score encompassing both physical health and mental health component scores, 116 and one study did not present any useful data, reporting data as deviation values from national reference values. 115 The limitations of the methodological designs of these studies and potential for bias should be considered in the interpretation of these data.…”

Obstructive sleep apnea in patients with interstitial lung diseases: past and future

“…This population has a high incidence of CPAP nonacceptance or poor compliance, which can only be eliminated through an intense follow-up by a wellorganized sleep center [12]. Although it is worth to overcome such difficulties since recent data show that effective CPAP treatment in IPF patients with OSA results in a significant improvement in daily living activities based on the Functional Outcomes in Sleep Questionnaire, namely an OSA specific follow-up instrument [13].…”