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
Setting: University sleep disorders
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.
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.