Obstructive sleep apnoea in the elderly: role of continuous positive airway pressure treatment
Por:
Martinez-Garcia, MA, Chiner, E, Hernandez, L, Cortes, JP, Catalan, P, Ponce, S, Diaz, JR, Pastor, E, Vigil, L, Carmona, C, Montserrat, JM, Aizpuru, F, Lloberes, P, Mayos, M, Selma, MJ, Cifuentes, JF, Munoz, A
Publicada:
1 jul 2015
Resumen:
Almost all the information about the effect of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnoea (OSA) comes from clinical trials involving only middle-aged patients. The objective of this study was to assess the effect of CPAP treatment in elderly patients with severe OSA on clinical, quality-of-life and neurocognitive spheres.
We performed an open-label, randomised, multicentre clinical trial in a consecutive clinical cohort of 224 elderly (>= 70 years old) patients with confirmed severe OSA (apnoea-hypopnea index >= 30) randomised to receive CPAP (n = 115) or no CPAP (n = 109) for 3 months. A sleep study was performed by either full polysomnography or respiratory polygraphy. CPAP titration was performed by an autoCPAP device. The primary endpoint was quality of life (Quebec Sleep Questionnaire) and secondary endpoints included sleep-related symptoms, presence of anxiety/depression, office-based blood pressure and some neurocognitive tests.
The mean +/- SD age was 75.5 +/- 3.9 years. The CPAP group achieved a greater improvement in all quality-of- life domains (p < 0.001; effect size: 0.41-0.98), sleep-related symptoms (p < 0.001; effect size 0.31-0.91) as well as anxiety (p = 0.016; effect size 0.51) and depression (p < 0.001; effect size: 0.28) indexes and some neurocognitive tests (digit symbol test (p = 0.047; effect size: 0.20) and Trail Making Test A (p = 0.029; effect size: 0.44)) in an intention-to-treat analysis.
In conclusion, CPAP treatment resulted in an improvement in quality of life, sleep-related symptoms, anxiety and depression indexes and some neurocognitive aspects in elderly people with severe OSA.
Filiaciones:
Martinez-Garcia, MA:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia 46026, Spain
CIBER Enfermedades Resp CibeRes CB06 06, Bunyola, Spain
Chiner, E:
Hosp Univ San Juan, Resp Dept, Alicante, Spain
Hernandez, L:
Hosp Gen Univ, Resp Dept, Alicante, Spain
Cortes, JP:
Hosp La Plana, Resp Dept, Castellon de La Plana, Spain
Catalan, P:
Hosp Gen Requena, Resp Dept, Valencia, Spain
Ponce, S:
Hosp Univ Peset, Resp Dept, Valencia, Spain
Diaz, JR:
Univ Hosp, Resp Dept, Castellon de La Plana, Spain
Pastor, E:
Hosp Torrevieja, Resp Dept, Alicante, Spain
Vigil, L:
Corp Sanitaria Parc Tauli, Hosp Sabadell, Resp Dept, Barcelona, Spain
Carmona, C:
CIBER Enfermedades Resp CibeRes CB06 06, Bunyola, Spain
Hosp Univ Virgen del Rocio, Resp Dept, Seville, Spain
Montserrat, JM:
IDIBAPS Hosp Clin, Resp Dept, Barcelona, Spain
Aizpuru, F:
BioAraba, Araba Hlth Res Unit, Vitoria, Spain
Lloberes, P:
Hosp Univ Vall Hebron, Resp Dept, Barcelona, Spain
Mayos, M:
Hosp Univ Santa Creu & St Pau, Resp Dept, Barcelona, Spain
Selma, MJ:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia 46026, Spain
Cifuentes, JF:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia 46026, Spain
Munoz, A:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia 46026, Spain
Bronze
|