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Clinical Investigations: SLEEP |

Quality of Life in Patients with Obstructive Sleep Apnea*: Effect of Nasal Continuous Positive Airway Pressure—A Prospective Study

Carolyn D’Ambrosio, MD; Teri Bowman, MD; Vahid Mohsenin, MD
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*From the Yale Center for Sleep Disorders, Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT.



Chest. 1999;115(1):123-129. doi:10.1378/chest.115.1.123
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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.

Study objective: To determine the effect of nCPAP on the quality of life in patients with OSA.

Design: Prospective 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 events/h.

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

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