CPAP improves quality of life for patients with mild OSA
Most patients with obstructive sleep apnea have mild disease. Continuous positive airway pressure (CPAP) therapy is effective in improving sleep related symptoms (e.g. excessive daytime sleepiness) among patients with moderate to severe OSA. However, less attention has been paid to symptom improvement among those with mild disease (apnea hypopnea index, AHI, 5-14.9). Adding further complexity, two definitions of AHI are in use which differ in the definition of hypopneas. The 2007 AHI criteria only includes hypopneas with 4% oxygen desaturations, whereas the more sensitive 2012 criteria allows hypopneas associated with either 3% desaturations OR arousals.(AASM Criteria) Some patients classified as mild on the 2012 definition, may not have OSA based on the 2007 criteria. Given the lack of consensus around effectiveness of treatment, management of patients with mild OSA varies widely worldwide.
Dr. Wimms et al conducted a randomized control trial to help address this knowledge gap. The investigators randomized patients with mild OSA by either AHI criteria to either CPAP or sleep hygiene education. The authors found patients randomized to CPAP had greater improvement in the primary endpoint of vitality (as measured by SF-36 subscore). Patients with CPAP improved 9.2 points on the 100 point scale (95% CI 6.8-11.6) vs. -0.8 points (-3.2 to 1.5) for those treated with sleep hygiene advice alone. Improvement with CPAP was also seen across various definitions of mild OSA, including those classified as normal based on the AASM 2007 criteria. Together, these results support the effectiveness of CPAP to improve quality of life among patients with mild OSA.
https://www.ncbi.nlm.nih.gov/pubmed/31806413
(Post by: Lucas Donovan)
