Document Detail


Effectiveness of CPAP treatment in daytime function in sleep apnea syndrome: a randomized controlled study with an optimized placebo.
MedLine Citation:
PMID:  11520724     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Application of continuous positive airway pressure (CPAP) as the standard treatment for sleep apnea/hypopnea syndrome (SAHS) is a moot point. Studies on the effectiveness of this treatment have been challenged because of the lack of a suitable placebo. The recent description of a true placebo (sham CPAP) prompted us to conduct a randomized trial of CPAP or placebo to assess the effectiveness of CPAP in improving SAHS-related symptoms and daytime function in patients with moderate to severe SAHS. Forty-eight patients, stratified in four groups according to severity, were randomly allocated into two treatment groups (optimal and sham CPAP) for a 6-wk period. Of these, 45 completed follow-up (91% males; age: 54 +/- 10 yr; body mass index [BMI]: 32 +/- 6 kg/m(2); apnea-hypopnea index [AHI]: 54 +/- 19 events/h; and Epworth Sleepiness Scale [ESS]: 16 +/- 5). The ESS, a questionnaire on SAHS-related symptoms, Functional Outcomes Sleep Questionnaire (FOSQ), and the Short Form Health Survey (SF-36) were completed at inclusion and after treatment. After 10 d of washout, the placebo group was treated with optimal CPAP and reassessed before and after optimal CPAP. The group receiving optimal CPAP when compared with the group with sham CPAP showed considerably greater improvement in the relief of sleepiness (-9.5 versus -2.3, p < 0.001), other SAHS-related symptoms (-18.5 versus -4.5, p < 0.001), vigilance (+8.5 versus +3.4, p = 0.009), and general productivity (+4.0 versus +0.5, p = 0.04) FOSQ scales. Both groups used a similar number of hours for the optimal and the sham CPAP (4.3 versus 4.5, (p = NS). The patients initially treated with placebo CPAP improved significantly more when optimal CPAP was applied for ESS (-2.3 versus -6.7, p < 0.001) and other sleep apnea syndrome (SAS)-related symptoms (-4.5 versus -11.2, p = 0.02). Our study provides strong evidence of the effectiveness of CPAP treatment in improving symptoms and perceived health status in moderate to severe SAHS.
Authors:
J M Montserrat; M Ferrer; L Hernandez; R Farré; G Vilagut; D Navajas; J R Badia; E Carrasco; J De Pablo; E Ballester
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  164     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-24     Completed Date:  2001-10-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  608-13     Citation Subset:  AIM; IM    
Affiliation:
Institut Clínic de Pneumologia i Cirurgia Toràcica and Servei de Psiquiatria, Hospital Clínic, Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living*
Adult
Aged
Attitude to Health
Body Mass Index
Double-Blind Method
Female
Follow-Up Studies
Health Status
Humans
Male
Middle Aged
Obesity / chemically induced,  complications
Placebos
Positive-Pressure Respiration / methods*,  psychology,  standards
Questionnaires
Severity of Illness Index
Sleep Apnea Syndromes / diagnosis,  etiology,  physiopathology*,  therapy*
Sleep Stages*
Smoking / adverse effects
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Placebos

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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