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Are symptoms of obstructive sleep apnoea related to good continuous positive airway pressure compliance?

ABSTRACT: Obstructive sleep apnoea (OSA) is a common disease that can be treated with continuous positive airway pressure (CPAP). CPAP tolerance may be associated with its compliance. Even though there are several predictors for good CPAP compliance, there are limited data available on the correlation between CPAP compliance and OSA symptoms. This study aimed to evaluate this correlation. We conducted a cross-sectional study and enrolled adult patients diagnosed with OSA through polysomnography who had experience using a CPAP machine. A self-report questionnaire was used to evaluate CPAP compliance and study variables. Predictors of CPAP compliance were analysed using stepwise multivariate logistic regression analysis. There were 68 patients with OSA who completed the questionnaire during the study period. Of those, 14 (20.59%) exhibited good CPAP compliance. Only fatigue as a symptom was an independent factor associated with good CPAP compliance, with an adjusted odds ratio of 5.380 (95% CI 1.274–22.719). In conclusion, fatigue was the only symptom associated with good CPAP compliance in patients with OSA. Fatigue improves CPAP compliance in OSA patientshttps://bit.ly/2R635zR

SUBMITTER: Kaewkes C

PROVIDER: S-EPMC7520172 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Obstructive Sleep Apnoea Syndrome: Continuous Positive Airway Pressure Therapy for Prevention of Cardiovascular Risk

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| S-EPMC7539148 | biostudies-literature

Predictive equation for optimal continuous positive airway pressure in children with obstructive sleep apnoea.

Project description:A subgroup of children with obstructive sleep apnoea (OSA) requires treatment with continuous positive airway pressure (CPAP). This study's aims were: 1) to determine if the optimal CPAP for the treatment of OSA in children correlates with body mass index (BMI); 2) to determine the correlation between polysomnographic variables and optimal CPAP in children with OSA; and 3) to develop a CPAP predictive equation for children with OSA. This was a retrospective study of children with OSA who underwent CPAP titration studies. Patients with craniofacial abnormalities (except Down syndrome) and neuromuscular diseases were excluded. Polysomnograms were done using Sandman Elite. Correlations between optimal CPAP, clinical and polysomnographic variables were analysed. A multivariable linear regression model for optimal CPAP was developed. 198 children (mean±sd age 13.1±3.6 years) were studied. Optimal CPAP had a significant positive correlation with age (rho=0.216, p=0.002), obstructive apnoea-hypopnoea index (rho=0.421, p<0.001), 3% oxygen desaturation index (rho=0.417, p<0.001), rapid eye movement respiratory disturbance index (rho=0.378, p<0.001) and BMI z-score (rho=0.160, p=0.024); and a significant negative correlation with arterial oxygen saturation measured by pulse oximetry nadir (rho= -0.333, p<0.001). The predictive equation derived was:Optimal CPAP (cmH2O)=6.486+0.273·age (years)-0.664·adenotonsillectomy(no=1, yes=0)+2.120·Down syndrome (yes=1, no=0)+0.280·BMI z-score. The equation developed may help to predict optimal CPAP in children with OSA. Further studies are required to validate this equation and to determine its applicability in different populations.

| S-EPMC7276523 | biostudies-literature

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Treatment burden experienced by patients with obstructive sleep apnoea using continuous positive airway pressure therapy.

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Prevalence of obstructive sleep apnoea in REM behaviour disorder: response to continuous positive airway pressure therapy.

Project description:ObjectivesRapid eye movement behaviour disorder (RBD) is a parasomnia in which there is loss of muscle atonia during rapid eye movement (REM) sleep, resulting in dream enactment. The aims of this study were to determine the prevalence of obstructive sleep apnoea (OSA) in RBD patients and determine whether continuous positive airway pressure (CPAP) therapy improved RBD symptoms in patients with concomitant RBD and OSA.MethodsA questionnaire was mailed to 120 patients identified from a tertiary sleep centre with RBD meeting full International Classification for Sleep Disorders-3 (ICSD-3) criteria. Patients were diagnosed as having OSA if they had an apnoea-hypopnea index (AHI) ≥ 5. The questionnaire focused on CPAP-use, compliance and complications. Standard statistical analysis was undertaken using SPSS (v.21, IBM).ResultsOne hundred and seven of the potential participants (89.2%) had an OSA diagnosis. Out of 72 who responded to the questionnaire, (60%) 27 patients were using CPAP therapy. CPAP therapy improved RBD symptoms in 45.8% of this group. Despite this positive response to treatment in nearly half of CPAP-users, there was no significant difference in subjective or objective CPAP compliance between those who reported RBD improvement and those who did not. Subjective compliance with CPAP was over-reported, with mean usage being 7.17 ± 1.7 h per night compared to objective mean compliance of 5.71 ± 1.7.ConclusionsOSA is a very common co-morbidity of RBD. CPAP therapy might improve self-reported RBD symptoms further, in addition to standard RBD treatment. However, further research into its topic is necessary.

| S-EPMC6133117 | biostudies-literature

Impact of COVID-19 lockdown on adherence to continuous positive airway pressure by obstructive sleep apnoea patients.

Project description: Not available

| S-EPMC7241111 | biostudies-literature

Effects of continuous positive airway pressure on depression and anxiety symptoms in patients with obstructive sleep apnoea: results from the sleep apnoea cardiovascular Endpoint randomised trial and meta-analysis.

Project description:BackgroundWhether continuous positive airway pressure (CPAP) treatment can improve depression or anxiety symptoms in obstructive sleep apnoea (OSA) patients remains uncertain.MethodsSecondary analysis of the Sleep Apnea Cardiovascular Endpoints (SAVE) trial, combined with a systematic review of randomised evidence. The SAVE secondary analyses involved 2410 patients with co-existing moderate-severe OSA and established cardiovascular disease randomly allocated to CPAP treatment plus usual care or usual care alone and followed up for 3·7 (SD 1·6) years. We evaluated the effect of CPAP treatment on depression and anxiety caseness (scores ≥ 8 on the Hospital Anxiety and Depression Scale depression and anxiety subscales [HADS-D and HADS-A]) for OSA patients.FindingsCPAP treatment was associated with reduced odds of depression caseness (adjusted odds ratio [OR] 0·80, 95% confidence interval [CI] 0·65-0·98, P = 0·031) compared to usual care in the SAVE trial and the treatment effect was greater in those with pre-existing depression symptoms. A systematic review of 20 randomised trials including 4255 participants confirmed a benefit of CPAP in reducing depression symptoms in OSA patients: the overall effect (standardised mean difference) was - 0·18 (95% CI - 0·24 to - 0·12). No effect of CPAP treatment on anxiety caseness was found both in patients of the SAVE study (adjusted OR 0·98, 95% CI 0·78-1·24, P = 0·89) and the systematic review.InterpretationCPAP reduces depression symptoms in patients with co-existing OSA and CVD independently of improvements in sleepiness.

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Anxiety and Depression in Patients with Obstructive Sleep Apnoea before and after Continuous Positive Airway Pressure: The ADIPOSA Study.

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Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea.

Project description: Not available

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Obesity does not modify the effect of continuous positive airway pressure on insulin resistance in adults with obstructive sleep apnoea.

Project description:This study found no evidence that obesity significantly modifies the effect of 4 months of CPAP treatment on HOMA-IR. Longer duration of CPAP treatment may be needed in order to reduce insulin resistance and determine whether obesity modifies the effect. https://bit.ly/3CtX7jZ.

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