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The role of CPAP treatment in elderly patients with moderate obstructive sleep apnea. A Multicenter Randomised Controlled Trial

S. Ponce, E. Pastor, B. Orosa, G. Oscullo, P. Catalán, A. Martinez, L. Hernandez, A. Muriel, E. Chiner, M.A. Martinez-Garcia on behalf the group of sleep respiratory disorders of the Sociedad Valenciana de Neumología
European Respiratory Journal 2019; DOI: 10.1183/13993003.00518-2019
S. Ponce
1Pneumology Department, Hospital Universitario Dr Peset, Valencia, Spain
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E. Pastor
2Pneumology Department, Hospital Universitario San Juan, Alicante, Spain
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B. Orosa
1Pneumology Department, Hospital Universitario Dr Peset, Valencia, Spain
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G. Oscullo
3Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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P. Catalán
4Internal Medicine Department, Hospital General de Requena, Valencia, Spain
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A. Martinez
5Pneumology Departmenty, Hospital General Universitario de Castellón, Spain
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L. Hernandez
6Pneumology Department, Hospital General Universitario de Alicante, Valencia
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A. Muriel
7Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERESP, Nursing Department, Alcala University, Madrid, Spain
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E. Chiner
2Pneumology Department, Hospital Universitario San Juan, Alicante, Spain
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M.A. Martinez-Garcia
3Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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  • For correspondence: mianmartinezgarcia@gmail.com
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Abstract

The efficacy of continuous positive airway pressure (CPAP) treatment in elderly patients with non-severe obstructive sleep apnea (OSA) is controversial.

The objective of this study was to assess the effect of CPAP treatment in elderly patients with moderate OSA on clinical, quality of life and neurocognitive spheres.

Open-label, randomised, multicenter clinical trial in 143 elderly (≥70 years old) patients with confirmed moderate OSA (apnea-hypopnea index between 15 and 29.9 events·h−1) randomised to receive CPAP (n=73) or no CPAP (n=72) for 3 months. The primary endpoint was the Epworth Sleepiness Scale (ESS) value, and the secondary endpoints included quality of life (Quebec Sleep Questionnaire [QSQ]), sleep-related symptoms, presence of anxiety/depression, office-based blood pressure measurements and some neurocognitive tests. The analysis was performed according to the intention-to-treat principle.

Mean (sd) age was 74.9 (4.6) years. The CPAP group achieved a greater improvement in the EES value (adjusted difference of 2.6 [95%CI: 3.6–1.6], effect size: 1), in some sleep-related symptoms and in some dimensions of the QSQ questionnaire (nocturnal symptoms: 0.7 [95%CI: 0.3–1];p<0.0001, and emotions: 0.4 (0.1–0.7);p=0.023). However, CPAP did not demonstrate any effect on either the neurocognitive tests (including anxiety and depression) or the blood pressure levels. There was a positive correlation between the effect of CPAP and the improvement in EES values and quality of life domains.

CPAP treatment resulted in a significant improvement in diurnal hypersomnia and some sleep-related symptoms and quality of life domains in elderly patients with moderate OSA.

Clinical trial registered with www.clinicaltrials.gov (NCT03079466)

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: SP has no conflict of interest

Conflict of interest: EP has no conflict of interest

Conflict of interest: BO has no conflict of interest

Conflict of interest: GO has no conflict of interest

Conflict of interest: PC has no conflict of interest

Conflict of interest: AM has no conflict of interest

Conflict of interest: LH has no conflict of interest

Conflict of interest: AM has no conflict of interest

Conflict of interest: EC has no conflict of interest

Conflict of interest: MAMG has no conflict of interest

This is a PDF-only article. Please click on the PDF link above to read it.

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The role of CPAP treatment in elderly patients with moderate obstructive sleep apnea. A Multicenter Randomised Controlled Trial
S. Ponce, E. Pastor, B. Orosa, G. Oscullo, P. Catalán, A. Martinez, L. Hernandez, A. Muriel, E. Chiner, M.A. Martinez-Garcia
European Respiratory Journal Jan 2019, 1900518; DOI: 10.1183/13993003.00518-2019

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The role of CPAP treatment in elderly patients with moderate obstructive sleep apnea. A Multicenter Randomised Controlled Trial
S. Ponce, E. Pastor, B. Orosa, G. Oscullo, P. Catalán, A. Martinez, L. Hernandez, A. Muriel, E. Chiner, M.A. Martinez-Garcia
European Respiratory Journal Jan 2019, 1900518; DOI: 10.1183/13993003.00518-2019
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