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Clinical Investigations: SLEEP AND BREATHING |

Can Continuous Positive Airway Pressure Therapy Improve the General Health Status of Patients With Obstructive Sleep Apnea?*: A Clinical Effectiveness Study

Don D. Sin, MD, MPH; Irvin Mayers, MD, FCCP; Godfrey C.W. Man, MBBS, FCCP; Ali Ghahary, BSc; Lawrence Pawluk, MD
Author and Funding Information

*From the Departments of Pulmonary Medicine (Drs. Sin, Mayers, and Man, and Mr. Ghahary) and Psychiatry (Dr. Pawluk), University of Alberta, Edmonton, AB, Canada.

Correspondence to: Don D. Sin, MD, MPH, 2E4.29 Walter C. Mackenzie Center, University of Alberta, Edmonton, AB, Canada. T6G 2B7; e-mail: don.sin@ualberta.ca



Chest. 2002;122(5):1679-1685. doi:10.1378/chest.122.5.1679
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Study objectives: To determine the short-term and long-term impacts of continuous positive airway pressure (CPAP) therapy on health-related quality of life (HRQL) in patients with obstructive sleep apnea (OSA).

Design: Prospective longitudinal cohort study.

Setting: University sleep disorders center.

Patients: Three hundred sixty-five patients with an apnea-hypopnea index (AHI) ≥ 20 per hour of sleep and 358 patients with an AHI of < 20.

Interventions: All patients with AHIs ≥ 20 received CPAP therapy; those with AHIs < 20 did not. The HRQL of all study participants was measured using the 36-item medical outcomes study short form (SF-36) questionnaire at baseline and then at 3 and 12 months of follow-up.

Results: Although the SF-36 scores were similar at baseline, after 3 months of therapy, the CPAP group had higher adjusted emotional summary scores than did those who did not receive CPAP therapy (score increase, 1.72; 95% confidence interval [CI], 0.08 to 3.37). These improvements were maintained for 12 months. The gains in the SF-36 scores were most striking in the vitality domain (score increase, 10.52; 95% CI, 7.04 to 14.00 U increment). The severe OSA group (ie, AHIs ≥ 40) experienced the largest benefit. Their adjusted vitality scores were 12.3 U higher (95% CI, 8.0 to 16.6) than those persons without OSA (ie, AHIs< 5).

Conclusions: CPAP therapy was associated with marked short-term and long-term improvements in the vitality of patients with moderate-to-severe OSA in the community. These findings suggest that CPAP therapy is effective in improving the long-term HRQL of patients with OSA.

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