Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome

Engleman, Heather M.; Martin, Sascha E.; Douglas, Neil J.; Deary, Ian J.

doi:10.1016/s0140-6736(94)91522-9

Cited by 543 publications

(361 citation statements)

References 21 publications

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“…1). However, this observation is in keeping with a previous study assessing its effects in the short-term [12]. To explain these observations, several potential explanations can be considered.…”

Section: Discussionsupporting

confidence: 88%

Long-term effects of CPAP on daytime functioning in patients with sleep apnoea syndrome

Muñoz¹,

Mayoralas²,

Barbé³

et al. 2000

Eur Respir J

136

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Daytime sleepiness, impaired cognitive performance and dysphoric mood are often present in patients with obstructive sleep apnoea syndrome (SAS). This prospective controlled study evaluates the effects of treatment with continuous positive airway pressure (CPAP) during 1 yr on daytime functioning in a large group of patients with SAS.The authors studied 80 patients (mean SEM 49 1 yrs) with SAS with a mean apnoea-hypopnoea index of 60 2 h -1 , and 80 healthy control subjects matched for sex and age (46 1 yrs.). Measurements were obtained at the beginning of the study and 12 1 months later, and included: daytime sleepiness (Epworth scale), depression and anxiety (Beck tests), vigilance (Steer-Clear1) and reaction time (Psychometer Vigilance Test 1921). Drug, coffee and alcohol intake, as well as the sleep schedule, were also recorded.Results showed that, before treatment, patients were more somnolent (p<0.001), anxious (p<0.01) and depressed (p<0.001) than control subjects. Also, they had a longer reaction time (p<0.05) and poorer vigilance (p<0.01). The use of CPAP improved significantly the levels of somnolence (p<0.0001) and vigilance (p<0.01), but failed to modify anxiety and depression. Reaction time changes were minor. Variables with a potential confounding effect did not change during the study.These results provide firm evidence to substantiate the use of continuous positive airway pressure in patients with sleep apnoea syndrome. Eur Respir J 2000; 15: 676±681.

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Section: Discussionsupporting

confidence: 88%

Long-term effects of CPAP on daytime functioning in patients with sleep apnoea syndrome

Muñoz¹,

Mayoralas²,

Barbé³

et al. 2000

Eur Respir J

136

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“…In this study patients were followed for 4 weeks. The results remarkably resembled those in the studies by ENGLEMAN et al [12,13,19], showing that the measures of subjective well-being improved about two-fold compared with placebo. Therefore, from the short-term studies available it can be deduced that placebo or subtherapeutic CPAP have measurable positive effects on subjective well-being, but that there is a clear quantitative difference between CPAP and placebo effects.…”

Section: Discussionsupporting

confidence: 83%

“…Previous research on quality of life measures demonstrated that short-term treatment with CPAP for 4 or 5 weeks, respectively, can improve cognitive performance [12], symptoms of OSAS and daytime function [13,19], and quality of life [14,15,18]. A recently published study demonstrated that the relief of sleepiness and other OSAS-related clinical symptoms and improvement in perceived health status was much greater in patients receiving conservative and CPAP treatment compared with those only receiving conservative treatment, even after 3 months of treatment [17].…”

Section: Discussionmentioning

confidence: 99%

“…To the authors' knowledge, there are four studies on the quality of life including a placebo group. ENGLEMAN et al [12] showed that during a 4-week course of CPAP therapy subjective well-being improved in the CPAP group by about twice the effect in the placebo group. In a smaller group of patients, a similar benefit of CPAP over placebo was reported by the same group [13].…”

Section: Discussionmentioning

confidence: 99%

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Long-term treatment with continuous positive airway pressure improves quality of life in obstructive sleep apnoea syndrome

Sanner¹,

Klewer²,

Trumm³

et al. 2000

Eur Respir J

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Continuous positive airway pressure (CPAP) is an established treatment of obstructive sleep apnoea syndrome (OSAS). While it is known that CPAP reverses the pathological breathing pattern and improves daytime sleepiness, there are no sufficient data on the long‐term influence of CPAP on quality of life in patients with OSAS. Thirty‐nine patients with polysomnographically verified OSAS (apnoea/hypopnoea index (AHI): (mean±sd) 46.8±21.8 events·h‐1) were prospectively studied. All patients answered three quality of life measures (Complaint List, Nottingham Health Profile Part 1 (NHP), and Verbal Analogue‐Scale “quality of life”) prior to the initiation of CPAP therapy. After a mean of 9 months they were re‐evaluated by polysomnography, and completed the questionnaires once again. As expected, CPAP was effective in treating the sleep‐related breathing disorder. AHI decreased significantly from (mean±sd) 46.8±21.8 events·h‐1 to 3.3±6.3 events·h‐1, and minimum oxygen saturation increased from 77.1±9.3% to 89.9±3.4%, while body mass index did not change significantly (31.3±5.4 versus 30.8±4.8 kg·m‐2). During long‐term treatment with CPAP the Complaint List revealed a significant improvement of the extent of subjective impairment due to physical and general complaints (26.4±9.9 versus 20.4±11.1), and NHP a significant improvement of emotional reactions (19.8±21.7 versus 11.1±14.0) and energy (50.8±36.6 versus 32.1±36.7), but not of pain, physical mobility, sleep, social isolation, and quality of life as assessed by the Verbal Analogue‐Scale. It is concluded that long‐term continuous positive airway pressure therapy is effective in improving not only pathological breathing patterns but also parameters that estimate quality of life in patients with obstructive sleep apnoea syndrome.

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“…Due to space limitations of this review, declines in vigilance associated with other conditions will not be discussed further, including attention-deficit hyperactivity disorder (Barkley et al, 1992), sleep apnea (Engleman and Martin, 1994;Verstraeten and Cluydts, 2004) and narcolepsy (Valley and Broughton, 1983).…”

Section: Conditions Associated With Changes In Alertness and Sustainementioning

confidence: 99%

Vigilance, alertness, or sustained attention: physiological basis and measurement

Oken

Salinsky

Elsas

2006

Clinical Neurophysiology

678

463

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Vigilance is a term with varied definitions but the most common usage is sustained attention or tonic alertness. This usage of vigilance implies both the degree of arousal on the sleep-wake axis and the level of cognitive performance. There are many interacting neural and neurotransmitter systems that affect vigilance. Most studies of vigilance have relied on states where the sleep-wake state is altered, e.g. drowsiness, sleep-deprivation, and CNS-active drugs, but there are factors ranging from psychophysics to motivation that may impact vigilance. While EEG is the most commonly studied physiologic measure of vigilance, various measures of eye movement and of autonomic nervous system activity have also been used. This review paper discusses the underlying neural basis of vigilance and its assessment using physiologic tools. Since, assessment of vigilance requires assessment of cognitive function this aspect is also discussed.

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Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome

Cited by 543 publications

References 21 publications

Long-term effects of CPAP on daytime functioning in patients with sleep apnoea syndrome

Long-term effects of CPAP on daytime functioning in patients with sleep apnoea syndrome

Long-term treatment with continuous positive airway pressure improves quality of life in obstructive sleep apnoea syndrome

Vigilance, alertness, or sustained attention: physiological basis and measurement

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