PURPOSE: To assess excessive daytime sleepiness, insomnia, and compliance in patients with OSA treated with CPAP.
METHODS: 25 adults were studied with a diagnosis of moderately severe obstructive sleep apnea diagnosed with baseline polysomnography (PSG) and followed by in lab CPAP titration study. No patients were evaluated who had any unstable medical or underlying psychiatric disorders. Only those with a respiratory disturbance index (RDI) on ideal clinical CPAP treatment level <10 events per hour and oxygen saturation >85% were included. Scores from SMI and ESS were collected at baseline and office follow-up.
RESULTS: There were 20 males and 5 females (mean age of 53). Means and standard deviations were: baseline RDI 44(28) and nadir oxygen saturation 78(8). CPAP titration data at the ideal CPAP level included the RDI 4(1) and nadir oxygen saturation 90(5). T-tests were significant comparing pre SMI 18/40(7) with post SMI 9/40(7) and pre ESS 12/24(6) with post ESS 7/24(5) demonstrating improvement with CPAP. Cronbach's alpha score finds the SMI to be a reliable measure of sleep continuity with a baseline score of 0.8 and at follow-up of 0.9. The mean number of months at follow-up was 10(6) with 22/25(88%) remaining on CPAP. Despite CPAP 28% (7/25) had ESS scores of 10 or greater and 16% (4/25) had SMI scores of 20 or greater. For the 3/25(12%) who were not using CPAP, one had an ESS score of >10 and none had an SMI score >20. T-tests were not significant when comparing pre and post ESS and SMI scores in those not remaining on CPAP.
CONCLUSION: There was improvement in the SMI and ESS scores after treatment with CPAP. This study supports the reliability of the SMI as a measure of sleep continuity. Patients who continued on CPAP therapy had statistically significant improvement in SMI and ESS scores compared with those not using CPAP at follow-up.
CLINICAL IMPLICATIONS: Patients with OSA present with symptoms of both disrupted sleep and hypersomnolence which are modified by CPAP therapy.
DISCLOSURE: Richard Bogan, No Financial Disclosure Information; No Product/Research Disclosure Information