Background: Obstructive sleep apnea (OSA) is a common
condition and is associated with excessive daytime sleepiness and
neuropsychological dysfunction. There is limited evidence on the effect
of OSA on the quality of life and its response to nasal
continuous positive airway pressure (nCPAP) treatment.
objective: To determine the effect of nCPAP on the quality of
life in patients with OSA.
determination of nCPAP effect in a case-series analysis.
Patients: We studied 29 patients (23 were male and 6 were
female) with a mean (± SE) age of 4.4 ± 2.3 years, a body mass
index 36.3 ± 2.0 kg/height (m)2, and a diagnosis of OSA
with respiratory disturbance index (RDI; apnea/hypopnea) of 77 ± 9
Measurements and results: The quality of
life was assessed by administering a Medical Outcomes Study Short
Form-36 questionnaire before and after 8 weeks of nCPAP therapy in
polysomnographically documented OSA. All dimensions of the quality of
life were significantly impaired when compared with an age- and
gender-matched population, expressed as a percentage of normative data:
physical functioning, 75%; vitality, 41%; role functioning (physical,
54%; emotional, 61%; social, 66%); general health, 88%; and mental
health, 76%. nCPAP therapy significantly improved the sleep-disordered
breathing and sleep fragmentation. The nCPAP level for the group was
9.4 ± 0.7 cm H2O. Eight weeks of nCPAP therapy improved
vitality (75%), social functioning (90%), and mental health
(96%). The magnitude of improvement was related to the degree
of quality of life impairment prior to treatment, rather than to the
severity of disease as measured by the RDI and arousal indices.
Conclusions: All aspects of the quality of life, from
physical and emotional health to social functioning, are markedly
impaired by OSA. nCPAP therapy improved those aspects related to
vitality, social functioning, and mental health.
Abbreviations: OSA = obstructive
sleep apnea; nCPAP = nasal continuous positive airway pressure;
SF-36 = Medical Outcomes Study Short Form-36; RDI = respiratory
disturbance index; SE = standard error