Effect of continuous positive airway pressure treatment on health-related quality of life and sleepiness in high cardiovascular risk individuals with sleep apnea: Best apnea interventions for research (BestAIR) Trial

Ying Y. Zhao, Rui Wang, Kevin J. Gleason, Eldrin F. Lewis, Stuart F. Quan, Claudia M. Toth, Michael Morrical, Michael Rueschman, Jia Weng, James H. Ware, Murray A. Mittleman, Susan Redline

Research output: Research - peer-reviewArticle

  • 1 Citations

Abstract

Study Objectives: The long-term effect of continuous positive airway pressure (CPAP) on health-related quality of life (HRQOL) in patients with high cardiovascular disease risk and obstructive sleep apnea (OSA) without severe sleepiness is uncertain. We aimed to determine the effect of CPAP treatment on HRQOL in individuals with moderate or severe OSA and cardiovascular disease (CVD) or multiple CVD risk factors without severe sleepiness. Methods: In this randomized, controlled, parallel group study, 169 participants were assigned to treatment with CPAP or the control group (conservative medical therapy [CMT] or CMT with sham CPAP). Analyses were based on an intention-to-treat approach. Linear mixed effect models were fitted to compare the changes in the Medical Outcomes Study Short Form-36 (SF-36) and in subjective sleepiness (Epworth Sleepiness Scale [ESS]) between groups from baseline to the average of 6- and 12-month measurements. Results: CPAP improved several domains of HRQOL including bodily pain (treatment effect 9.7 [95% confidence interval, CI 3.9 to 15.4]; p =.001), vitality (5.7 [95% CI 1.5 to 9.9]; p =.008), general health (8.2 [95% CI 3.7 to 12.7]; p <.001), physical functioning (5.5 [95% CI 1.1 to 10.0]; p =.016), and the physical health summary score (3.3 [95% CI 1.4 to 5.3]; p =.001). CPAP also resulted in less daytime sleepiness (mean change in ESS -1.0 point [95% CI -2.0 to -0.0]; p =.040). Conclusions: In patients with moderate-severe OSA at high risk of cardiovascular events and without severe sleepiness, CPAP improved daytime sleepiness and multiple domains of HRQOL over 6 to 12 months of follow-up, with the largest improvement observed for bodily pain.

LanguageEnglish (US)
JournalSleep
Volume40
Issue number4
DOIs
StatePublished - Apr 1 2017
Externally publishedYes

Fingerprint

Continuous Positive Airway Pressure
Sleep Apnea Syndromes
Apnea
Quality of Life
Research
Therapeutics
Obstructive Sleep Apnea
Cardiovascular Diseases
Pain
Health
Conservative Treatment
Outcome Assessment (Health Care)
Confidence Intervals
Control Groups

Keywords

  • Clinical trial
  • CPAP
  • Quality of life
  • Sleep apnea
  • Sleepiness

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)

Cite this

Effect of continuous positive airway pressure treatment on health-related quality of life and sleepiness in high cardiovascular risk individuals with sleep apnea : Best apnea interventions for research (BestAIR) Trial. / Zhao, Ying Y.; Wang, Rui; Gleason, Kevin J.; Lewis, Eldrin F.; Quan, Stuart F.; Toth, Claudia M.; Morrical, Michael; Rueschman, Michael; Weng, Jia; Ware, James H.; Mittleman, Murray A.; Redline, Susan.

In: Sleep, Vol. 40, No. 4, 01.04.2017.

Research output: Research - peer-reviewArticle

Zhao, Ying Y. ; Wang, Rui ; Gleason, Kevin J. ; Lewis, Eldrin F. ; Quan, Stuart F. ; Toth, Claudia M. ; Morrical, Michael ; Rueschman, Michael ; Weng, Jia ; Ware, James H. ; Mittleman, Murray A. ; Redline, Susan. / Effect of continuous positive airway pressure treatment on health-related quality of life and sleepiness in high cardiovascular risk individuals with sleep apnea : Best apnea interventions for research (BestAIR) Trial. In: Sleep. 2017 ; Vol. 40, No. 4.
@article{2bd9c92440464179833540bb89c88e2c,
title = "Effect of continuous positive airway pressure treatment on health-related quality of life and sleepiness in high cardiovascular risk individuals with sleep apnea: Best apnea interventions for research (BestAIR) Trial",
abstract = "Study Objectives: The long-term effect of continuous positive airway pressure (CPAP) on health-related quality of life (HRQOL) in patients with high cardiovascular disease risk and obstructive sleep apnea (OSA) without severe sleepiness is uncertain. We aimed to determine the effect of CPAP treatment on HRQOL in individuals with moderate or severe OSA and cardiovascular disease (CVD) or multiple CVD risk factors without severe sleepiness. Methods: In this randomized, controlled, parallel group study, 169 participants were assigned to treatment with CPAP or the control group (conservative medical therapy [CMT] or CMT with sham CPAP). Analyses were based on an intention-to-treat approach. Linear mixed effect models were fitted to compare the changes in the Medical Outcomes Study Short Form-36 (SF-36) and in subjective sleepiness (Epworth Sleepiness Scale [ESS]) between groups from baseline to the average of 6- and 12-month measurements. Results: CPAP improved several domains of HRQOL including bodily pain (treatment effect 9.7 [95% confidence interval, CI 3.9 to 15.4]; p =.001), vitality (5.7 [95% CI 1.5 to 9.9]; p =.008), general health (8.2 [95% CI 3.7 to 12.7]; p <.001), physical functioning (5.5 [95% CI 1.1 to 10.0]; p =.016), and the physical health summary score (3.3 [95% CI 1.4 to 5.3]; p =.001). CPAP also resulted in less daytime sleepiness (mean change in ESS -1.0 point [95% CI -2.0 to -0.0]; p =.040). Conclusions: In patients with moderate-severe OSA at high risk of cardiovascular events and without severe sleepiness, CPAP improved daytime sleepiness and multiple domains of HRQOL over 6 to 12 months of follow-up, with the largest improvement observed for bodily pain.",
keywords = "Clinical trial, CPAP, Quality of life, Sleep apnea, Sleepiness",
author = "Zhao, {Ying Y.} and Rui Wang and Gleason, {Kevin J.} and Lewis, {Eldrin F.} and Quan, {Stuart F.} and Toth, {Claudia M.} and Michael Morrical and Michael Rueschman and Jia Weng and Ware, {James H.} and Mittleman, {Murray A.} and Susan Redline",
year = "2017",
month = "4",
doi = "10.1093/sleep/zsx040",
volume = "40",
journal = "Sleep",
issn = "0161-8105",
publisher = "American Academy of Sleep Medicine",
number = "4",

}

TY - JOUR

T1 - Effect of continuous positive airway pressure treatment on health-related quality of life and sleepiness in high cardiovascular risk individuals with sleep apnea

T2 - Sleep

AU - Zhao,Ying Y.

AU - Wang,Rui

AU - Gleason,Kevin J.

AU - Lewis,Eldrin F.

AU - Quan,Stuart F.

AU - Toth,Claudia M.

AU - Morrical,Michael

AU - Rueschman,Michael

AU - Weng,Jia

AU - Ware,James H.

AU - Mittleman,Murray A.

AU - Redline,Susan

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Study Objectives: The long-term effect of continuous positive airway pressure (CPAP) on health-related quality of life (HRQOL) in patients with high cardiovascular disease risk and obstructive sleep apnea (OSA) without severe sleepiness is uncertain. We aimed to determine the effect of CPAP treatment on HRQOL in individuals with moderate or severe OSA and cardiovascular disease (CVD) or multiple CVD risk factors without severe sleepiness. Methods: In this randomized, controlled, parallel group study, 169 participants were assigned to treatment with CPAP or the control group (conservative medical therapy [CMT] or CMT with sham CPAP). Analyses were based on an intention-to-treat approach. Linear mixed effect models were fitted to compare the changes in the Medical Outcomes Study Short Form-36 (SF-36) and in subjective sleepiness (Epworth Sleepiness Scale [ESS]) between groups from baseline to the average of 6- and 12-month measurements. Results: CPAP improved several domains of HRQOL including bodily pain (treatment effect 9.7 [95% confidence interval, CI 3.9 to 15.4]; p =.001), vitality (5.7 [95% CI 1.5 to 9.9]; p =.008), general health (8.2 [95% CI 3.7 to 12.7]; p <.001), physical functioning (5.5 [95% CI 1.1 to 10.0]; p =.016), and the physical health summary score (3.3 [95% CI 1.4 to 5.3]; p =.001). CPAP also resulted in less daytime sleepiness (mean change in ESS -1.0 point [95% CI -2.0 to -0.0]; p =.040). Conclusions: In patients with moderate-severe OSA at high risk of cardiovascular events and without severe sleepiness, CPAP improved daytime sleepiness and multiple domains of HRQOL over 6 to 12 months of follow-up, with the largest improvement observed for bodily pain.

AB - Study Objectives: The long-term effect of continuous positive airway pressure (CPAP) on health-related quality of life (HRQOL) in patients with high cardiovascular disease risk and obstructive sleep apnea (OSA) without severe sleepiness is uncertain. We aimed to determine the effect of CPAP treatment on HRQOL in individuals with moderate or severe OSA and cardiovascular disease (CVD) or multiple CVD risk factors without severe sleepiness. Methods: In this randomized, controlled, parallel group study, 169 participants were assigned to treatment with CPAP or the control group (conservative medical therapy [CMT] or CMT with sham CPAP). Analyses were based on an intention-to-treat approach. Linear mixed effect models were fitted to compare the changes in the Medical Outcomes Study Short Form-36 (SF-36) and in subjective sleepiness (Epworth Sleepiness Scale [ESS]) between groups from baseline to the average of 6- and 12-month measurements. Results: CPAP improved several domains of HRQOL including bodily pain (treatment effect 9.7 [95% confidence interval, CI 3.9 to 15.4]; p =.001), vitality (5.7 [95% CI 1.5 to 9.9]; p =.008), general health (8.2 [95% CI 3.7 to 12.7]; p <.001), physical functioning (5.5 [95% CI 1.1 to 10.0]; p =.016), and the physical health summary score (3.3 [95% CI 1.4 to 5.3]; p =.001). CPAP also resulted in less daytime sleepiness (mean change in ESS -1.0 point [95% CI -2.0 to -0.0]; p =.040). Conclusions: In patients with moderate-severe OSA at high risk of cardiovascular events and without severe sleepiness, CPAP improved daytime sleepiness and multiple domains of HRQOL over 6 to 12 months of follow-up, with the largest improvement observed for bodily pain.

KW - Clinical trial

KW - CPAP

KW - Quality of life

KW - Sleep apnea

KW - Sleepiness

UR - http://www.scopus.com/inward/record.url?scp=85019102143&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019102143&partnerID=8YFLogxK

U2 - 10.1093/sleep/zsx040

DO - 10.1093/sleep/zsx040

M3 - Article

VL - 40

JO - Sleep

JF - Sleep

SN - 0161-8105

IS - 4

ER -