Continuous Positive Airway Pressure Improves Quality of Life in Women with Obstructive Sleep Apnea. A Randomized Controlled Trial.
RATIONALE
Continuous positive airway pressure (CPAP) is the treatment of choice in patients with symptomatic obstructive sleep apnea (OSA). CPAP treatment improves quality of life (QoL) in men with OSA, but its role in women has not yet been assessed.


OBJECTIVES
To investigate the effect of CPAP on QoL in women with moderate to severe OSA.


METHODS
We conducted a multicenter, open-label randomized controlled trial in 307 consecutive women diagnosed with moderate to severe OSA (apnea-hypopnea index, ≥15) in 19 Spanish sleep units. Women were randomized to receive effective CPAP therapy (n = 151) or conservative treatment (n = 156) for 3 months. The primary endpoint was the change in QoL based on the Quebec Sleep Questionnaire. Secondary endpoints included changes in daytime sleepiness, mood state, anxiety, and depression. Data were analyzed on an intention-to-treat basis with adjustment for baseline values and other relevant clinical variables.


MEASUREMENTS AND MAIN RESULTS
The women in the study had a mean (SD) age of 57.1 (10.1) years and a mean (SD) Epworth Sleepiness Scale score of 9.8 (4.4), and 77.5% were postmenopausal. Compared with the control group, the CPAP group achieved a significantly greater improvement in all QoL domains of the Quebec Sleep Questionnaire (adjusted treatment effect between 0.53 and 1.33; P < 0.001 for all domains), daytime sleepiness (-2.92; P < 0.001), mood state (-4.24; P  = 0.012), anxiety (-0.89; P = 0.014), depression (-0.85; P = 0.016), and the physical component summary of the 12-item Short Form Health Survey (2.78; P = 0.003).


CONCLUSIONS
In women with moderate or severe OSA, 3 months of CPAP therapy improved QoL, mood state, anxiety and depressive symptoms, and daytime sleepiness compared with conservative treatment. Clinical trial registered with www.clinicaltrials.gov (NCT02047071).
['Campos-Rodriguez|Francisco|F|0000-0002-2632-3073', 'Queipo-Corona|Carlos|C|', 'Carmona-Bernal|Carmen|C|', 'Jurado-Gamez|Bernabe|B|', 'Cordero-Guevara|Jose|J|', 'Reyes-Nuñez|Nuria|N|', 'Troncoso-Acevedo|Fernanda|F|', 'Abad-Fernandez|Araceli|A|', 'Teran-Santos|Joaquin|J|', 'Caballero-Rodriguez|Julian|J|', 'Martin-Romero|Mercedes|M|', 'Encabo-Motiño|Ana|A|', 'Sacristan-Bou|Lirios|L|', 'Navarro-Esteva|Javier|J|', 'Somoza-Gonzalez|Maria|M|', 'Masa|Juan F|JF|', 'Sanchez-Quiroga|Maria A|MA|', 'Jara-Chinarro|Beatriz|B|', 'Orosa-Bertol|Belen|B|', 'Martinez-Garcia|Miguel A|MA|', '|||']
D000339:Affect D001007:Anxiety D045422:Continuous Positive Airway Pressure D003863:Depression D006970:Disorders of Excessive Somnolence D005260:Female D006801:Humans D008875:Middle Aged D011788:Quality of Life D020181:Sleep Apnea, Obstructive D013030:Spain D011795:Surveys and Questionnaires D016896:Treatment Outcome
continuous positive airway pressure quality of life women obstructive sleep apnea Quebec Sleep Questionnaire