CPAP reduces hypersomnia and sleep-related symptoms in elderly patients

27 August, 2019

Use of continuous positive airway pressure (CPAP) treatment in elderly patients with moderate obstructive sleep apnoea (OSA) results in a significant improvement in daytime sleepiness and some sleep-related symptoms, according to research published in the European Respiratory Journal (ERJ).

The researchers say that although the use of CPAP in elderly patients with non-severe OSA may be controversial, they wanted to assess the effects of CPAP treatment in terms of clinical, quality-of-life and neurocognitive measures.

To assess this, researchers conducted an open-label, randomised, multicentre clinical trial in 145 elderly patients (aged 70 years or more) with confirmed moderate OSA, who were randomised to receive CPAP or no CPAP for 12 weeks.

Sleep quality of the participants was measured at baseline via questionnaire using Epworth Sleepiness Scale (ESS) score, and further measures of sleep and quality of life were assessed using Quebec Sleep Questionnaire (QSQ) domain scores, sleep-related symptoms, presence of anxiety/depression, office-based blood pressure measurements and some neurocognitive tests. After 12 weeks, all patients completed a second round of questionnaires to measure those factors.

The primary outcome was change in ESS score over the duration of the study. Changes in the other measures were secondary outcomes. CPAP adherence was objectively measured by reading the device’s time counter from the beginning of treatment to the end of follow-up.

Compared with the group who did not use CPAP, the CPAP group achieved a greater improvement in Epworth Sleepiness Scale (ESS) values, in some sleep-related symptoms and in some aspects of the QSQ questionnaire.

The researchers say that CPAP did not demonstrate any effect on either neurocognitive tests (including anxiety and depression) or blood pressure levels. However, they highlight that there was a positive correlation between the effect of CPAP and the improvement in ESS scores and quality of life domains.

Study limitations include the fact that 75% of the sleep tests were conducted with home polygraphy rather than full polysomnography, and that there was no placebo group receiving sham-CPAP.