Quality of Life in Bed Partners of Patients With Obstructive Sleep Apnea or Hypopnea After Treatment With Continuous Positive Airway Pressure

Parish, James M.; Lyng, Philip J.

doi:10.1378/chest.124.3.942

Cited by 155 publications

(101 citation statements)

References 23 publications

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“…Nevertheless, persistent snoring with supine-avoidance therapy may limit the utility of this approach in patients with supine-predominant OSA. Snoring is one of the primary complaints in the clinical presentation of OSA that frequently disrupts bed partner sleep, affecting their own quality of life 18 and that of the snorer. Snoring may also contribute to cardiovascular risk.…”

Section: Discussionmentioning

confidence: 99%

“…Snoring very frequently disrupts the sleep of others, particularly affecting bed partner sleep and quality of life. 18 While there are some anecdotal reports of marked reductions in snoring with supine sleep avoidance, only one study appears to have examined the impact of positional therapy on snoring in positional OSA patients via objective snoring measurements. 19 This used indirect flow measurements without sound recordings, and found that snoring time remained unchanged with a severely restrictive positioning apparatus that was not tolerated by 22% (5/23) of patients studied.…”

Section: Subjectsmentioning

confidence: 99%

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Accurate Position Monitoring and Improved Supine-Dependent Obstructive Sleep Apnea with a New Position Recording and Supine Avoidance Device

Bignold

Mercer

Antic³

et al. 2011

Journal of Clinical Sleep Medicine

127

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Study Objectives: Approximately 30% of obstructive sleep apnea (OSA) patients have supine-predominant OSA, and simply avoiding supine sleep should normalise respiratory disturbance event rates. However, traditional supineavoidance therapies are inherently uncomfortable, and treatment adherence is poor and diffi cult to monitor objectively. This study evaluated the effi cacy of a novel, potentially more acceptable position monitor and supine-avoidance device for managing supine-predominant OSA and snoring. Design and Setting: In-laboratory evaluation of position recording accuracy versus video recordings (validation study), and randomized controlled crossover trial of active versus inactive supine-avoidance therapy in the home setting (effi cacy study). Patients: 17 patients undergoing in-laboratory sleep studies (validation) and 15 patients with supine-predominant OSA (effi cacy). Interventions: Effi cacy study: 1 week of inactive and 1 week of active treatment in randomized order, separated by 1 week. Measurements and Results: Agreement between 30-sec epoch-based posture classifi cations from device versus video records was high (median κ 0.95, interquartile range: 0.88-1.00), and there was good supine time agreement (bias 0.3%, 95%CI: −4.0% to 4.6%). In the effi cacy study, apnea-hypopnea index (AHI) and snoring frequency were measured in-home using a nasal pressure and microphone based system during inactive and active treatment weeks. The position monitoring and supine alarm device markedly inhibited supine time (mean ± SEM 19.3% ± 4.3% to 0.4% ± 0.3%, p < 0.001) and reduced AHI (25.0 ± 1.7 to 13.7 ± 1.1 events/h, p = 0.030) but not snoring frequency.

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Section: Discussionmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

Accurate Position Monitoring and Improved Supine-Dependent Obstructive Sleep Apnea with a New Position Recording and Supine Avoidance Device

Bignold

Mercer

Antic³

et al. 2011

Journal of Clinical Sleep Medicine

127

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“…Some females had unrecognised snoring. However, our data do not suggest that objective sleep quality improves substantially in the female nonsnoring partner when she sleeps alone for one night.KEYWORDS: Bed partner, sleep apnoea syndrome, snoring S leeping with a snoring partner has been reported to increase daytime feelings of stress, depression [1] and fatigue [2], although there were no consistent changes in quality of life evaluated through questionnaires [3,4] or in daytime sleepiness [4,5]. Poor sleep quality has been reported by more than twothirds of bed partners of snorers [3].…”

mentioning

confidence: 99%

“…leeping with a snoring partner has been reported to increase daytime feelings of stress, depression [1] and fatigue [2], although there were no consistent changes in quality of life evaluated through questionnaires [3,4] or in daytime sleepiness [4,5]. Poor sleep quality has been reported by more than twothirds of bed partners of snorers [3].…”

mentioning

confidence: 99%

“…Treatment of the snorer may bring relief to the partner. A few studies evaluated the sleep quality of those with bed partners whose sleep apnoea syndrome (SAS) was treated with continuous positive airway pressure (CPAP) [1,3,4,7,8]. Improvements were noted in the nonsnoring partners' daytime sleepiness scores (which were within the normal range at baseline) and in anxiety scores, but not in depression scores, after 6-8 weeks of CPAP [1].…”

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confidence: 99%

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Effect of sleeping alone on sleep quality in female bed partners of snorers

Blumen

Salva²,

d’Ortho³

et al. 2009

Eur Respir J

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The aim of the present study was to objectively measure the effect of sleeping alone for one night on sleep quality in female bed partners of male snorers.Females complaining of poor sleep due to snoring by their bed partner and having no known hearing loss or snoring were included in a prospective multicentre cross-sectional study. 23 females underwent one polysomnography recording while sleeping with their bed partner and another while sleeping alone. Their sleep parameters were compared between the two nights.We excluded seven couples because the female partner snored for .10% of the sleep time (n56) or had obstructive sleep apnoea syndrome (n51). In the remaining 16 females, sleep time, sleep efficiency, arousal index and percentages of deep sleep (stages 3-4) and rapid eye movement (REM) sleep were not significantly different between the two nights. Percentages of light sleep (non-REM stage 2) and awakening index were lower when sleeping alone (p50.023 and p50.046, respectively).Sleep quality was decreased and sleep fragmentation increased in females sleeping with male snorers. Some females had unrecognised snoring. However, our data do not suggest that objective sleep quality improves substantially in the female nonsnoring partner when she sleeps alone for one night.KEYWORDS: Bed partner, sleep apnoea syndrome, snoring S leeping with a snoring partner has been reported to increase daytime feelings of stress, depression [1] and fatigue [2], although there were no consistent changes in quality of life evaluated through questionnaires [3,4] or in daytime sleepiness [4,5]. Poor sleep quality has been reported by more than twothirds of bed partners of snorers [3]. These subjective complaints were related not only to snoring, but also to apnoeas and restlessness [3].Nonsnoring bed partners may try various methods to improve their sleep quality, such as using ear plugs or sleeping pills, or both [6]. Treatment of the snorer may bring relief to the partner. A few studies evaluated the sleep quality of those with bed partners whose sleep apnoea syndrome (SAS) was treated with continuous positive airway pressure (CPAP) [1,3,4,7,8]. Improvements were noted in the nonsnoring partners' daytime sleepiness scores (which were within the normal range at baseline) and in anxiety scores, but not in depression scores, after 6-8 weeks of CPAP [1]. In one of the few studies supplying objective data, CPAP during the second half of the study night was associated with a decreased arousal index and increased sleep efficiency in the partners [8]. In a cross-over study of CPAP versus placebo for 4 weeks each, CPAP was associated with better subjective sleep quality in the partner, but no improvements were noted in quality of life or objective sleep parameters (sleep efficiency, arousal index, sleep latency, time in slow wave sleep (SWS) and time in rapid eye movement (REM) sleep) [3].Some couples decide to sleep in separate rooms in order to improve their sleep quality. Among patients referred for snoring or suspected obstr...

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Cost-effectiveness of Continuous Positive Airway Pressure Therapy for Moderate to Severe Obstructive Sleep Apnea/Hypopnea

Ayas

FitzGerald²,

Fleetham³

et al. 2006

Arch Intern Med

137

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Background: Obstructive sleep apnea/hypopnea (OSAH) is a common disorder characterized by recurrent collapse of the upper airway during sleep, and is associated with an increased risk of motor vehicle crashes (MVCs). Common first-line therapy for OSAH is continuous positive airway pressure (CPAP). We assessed the cost-effectiveness of CPAP therapy vs none for the treatment of OSAH.Methods: We used a 5-year Markov model that considers the costs and quality-of-life improvements of CPAP therapy, accounting for the gains from reduced MVC rates. Utility values were obtained from published studies. The MVC rates under the CPAP and no-CPAP scenarios were calculated from National Highway Traffic Safety Administration data and a systematic review of published studies. Costs of MVCs, equipment, and physicians were obtained from US Medicare and the National Highway Traffic Safety Administration. The target population included male and female patients aged 25 to 54 years and newly diagnosed as having moderate to severe OSAH. We ex-amined the findings from the perspectives of a thirdparty payer and society.Results: From a third-party payer or a societal perspective, CPAP therapy was more effective but more costly than no CPAP, with incremental cost-effectiveness ratios of $3354 or $314 per quality-adjusted life-year gained, respectively. The incremental cost-effectiveness ratio estimate was most dependent on viewpoint (varying more than 10-fold between societal and third-party payer perspectives) and choice of utility measurement method (varying more than 5-fold between the use of standard gamble and EuroQol 5D utility assessment values). Conclusion:When quality of life, costs of therapy, and MVC outcomes are considered, CPAP therapy for patients with OSAH is economically attractive.

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Quality of Life in Bed Partners of Patients With Obstructive Sleep Apnea or Hypopnea After Treatment With Continuous Positive Airway Pressure

Cited by 155 publications

References 23 publications

Accurate Position Monitoring and Improved Supine-Dependent Obstructive Sleep Apnea with a New Position Recording and Supine Avoidance Device

Accurate Position Monitoring and Improved Supine-Dependent Obstructive Sleep Apnea with a New Position Recording and Supine Avoidance Device

Effect of sleeping alone on sleep quality in female bed partners of snorers

Cost-effectiveness of Continuous Positive Airway Pressure Therapy for Moderate to Severe Obstructive Sleep Apnea/Hypopnea

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