CPAP and health-related quality of life in adults with coronary artery disease and nonsleepy obstructive sleep apnea in the RICCADSA trial
(2019) In Journal of Clinical Sleep Medicine (JCSM) 15(9). p.1311-1320- Abstract
Study Objectives: To determine the effect of continuous positive airway pressure (CPAP) treatment on health-related quality of life (HRQoL) in adults with coronary artery disease (CAD) and nonsleepy obstructive sleep apnea (OSA). Methods: This was a secondary outcome analysis of the RICCADSA trial, conducted in Sweden between 2005 and 2013. Adults with CAD, nonsleepy OSA (apnea-hypopnea index [AHI] ≥ 15 events/h; Epworth Sleepiness Scale [ESS] score < 10) and complete Short-Form (SF)-36 questionnaires at baseline and after 12 months were included. Patients were randomized to CPAP (n = 102) or no CPAP (n = 104). The primary outcome was the between-group difference in absolute change in the SF-36 components. Within-group changes as... (More)
Study Objectives: To determine the effect of continuous positive airway pressure (CPAP) treatment on health-related quality of life (HRQoL) in adults with coronary artery disease (CAD) and nonsleepy obstructive sleep apnea (OSA). Methods: This was a secondary outcome analysis of the RICCADSA trial, conducted in Sweden between 2005 and 2013. Adults with CAD, nonsleepy OSA (apnea-hypopnea index [AHI] ≥ 15 events/h; Epworth Sleepiness Scale [ESS] score < 10) and complete Short-Form (SF)-36 questionnaires at baseline and after 12 months were included. Patients were randomized to CPAP (n = 102) or no CPAP (n = 104). The primary outcome was the between-group difference in absolute change in the SF-36 components. Within-group changes as well as variables associated with absolute change in the domains in the entire population were also tested. Results: Mean SF-36 scores were similar at baseline, ranging from 44.9 ± 9.6 to 92.2 ± 15.8 in various domains, and between-group changes from baseline were not statistically significant at 1 year. There was a significant increase in Role physical, Vitality, Role emotional, Mental health and Mental Component Summary (MCS), and a decrease in Bodily pain and General health scores in the CPAP group. The change in Physical Component Summary (PCS) was determined by female sex (beta coefficient −0.19, 95% confidence interval [CI] −7.25 to −0.98, P =.010), baseline AHI (beta coefficient −0.19, 95% CI −0.21 to −0.03, P =.009), CPAP use (h/night) (beta coefficient −0.16, 95% CI −0.93 to −0.06, P =.028), and acute myocardial infarction at baseline (beta coefficient 0.18, 95% CI 0.59 to 5.19, P =.014). Determinants of the change in MCS from baseline were change in the ESS score (beta coefficient −0.14, 95% CI −0.87 to −0.01, P =.054) and change in the Zung Self-rated Depression Scale scores (beta coefficient −0.33, 95% CI −0.58 to −0.24, P < .001). Conclusions: Assignment to CPAP treatment compared to no CPAP had no significant effect on HRQoL as measured by the SF-36 in adults with CAD and nonsleepy OSA. Although several components of the SF-36 scores were improved within the CPAP group, CPAP use was associated with a decrease in PCS. The improvement in MCS was determined by the improvement in daytime sleepiness and depressive mood. Clinical Trial Registration: Registry: ClinicalTrials.gov; Identifier: NCT00519597.
(Less)
- author
- Wallström, Sara ; Balcan, Baran ; Thunström, Erik ; Wolf, Axel and Peker, Yüksel LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiovascular disease, Health-related quality of life, SF-36, Sleep apnea
- in
- Journal of Clinical Sleep Medicine (JCSM)
- volume
- 15
- issue
- 9
- pages
- 10 pages
- publisher
- American Academy of Sleep Medicine
- external identifiers
-
- pmid:31482791
- scopus:85072329956
- ISSN
- 1550-9389
- DOI
- 10.5664/jcsm.7926
- language
- English
- LU publication?
- yes
- id
- a1cae507-4fd6-4549-9275-9b1ba5c67da5
- date added to LUP
- 2019-10-01 08:54:29
- date last changed
- 2024-04-16 21:50:23
@article{a1cae507-4fd6-4549-9275-9b1ba5c67da5,
abstract = {{<p>Study Objectives: To determine the effect of continuous positive airway pressure (CPAP) treatment on health-related quality of life (HRQoL) in adults with coronary artery disease (CAD) and nonsleepy obstructive sleep apnea (OSA). Methods: This was a secondary outcome analysis of the RICCADSA trial, conducted in Sweden between 2005 and 2013. Adults with CAD, nonsleepy OSA (apnea-hypopnea index [AHI] ≥ 15 events/h; Epworth Sleepiness Scale [ESS] score < 10) and complete Short-Form (SF)-36 questionnaires at baseline and after 12 months were included. Patients were randomized to CPAP (n = 102) or no CPAP (n = 104). The primary outcome was the between-group difference in absolute change in the SF-36 components. Within-group changes as well as variables associated with absolute change in the domains in the entire population were also tested. Results: Mean SF-36 scores were similar at baseline, ranging from 44.9 ± 9.6 to 92.2 ± 15.8 in various domains, and between-group changes from baseline were not statistically significant at 1 year. There was a significant increase in Role physical, Vitality, Role emotional, Mental health and Mental Component Summary (MCS), and a decrease in Bodily pain and General health scores in the CPAP group. The change in Physical Component Summary (PCS) was determined by female sex (beta coefficient −0.19, 95% confidence interval [CI] −7.25 to −0.98, P =.010), baseline AHI (beta coefficient −0.19, 95% CI −0.21 to −0.03, P =.009), CPAP use (h/night) (beta coefficient −0.16, 95% CI −0.93 to −0.06, P =.028), and acute myocardial infarction at baseline (beta coefficient 0.18, 95% CI 0.59 to 5.19, P =.014). Determinants of the change in MCS from baseline were change in the ESS score (beta coefficient −0.14, 95% CI −0.87 to −0.01, P =.054) and change in the Zung Self-rated Depression Scale scores (beta coefficient −0.33, 95% CI −0.58 to −0.24, P < .001). Conclusions: Assignment to CPAP treatment compared to no CPAP had no significant effect on HRQoL as measured by the SF-36 in adults with CAD and nonsleepy OSA. Although several components of the SF-36 scores were improved within the CPAP group, CPAP use was associated with a decrease in PCS. The improvement in MCS was determined by the improvement in daytime sleepiness and depressive mood. Clinical Trial Registration: Registry: ClinicalTrials.gov; Identifier: NCT00519597.</p>}},
author = {{Wallström, Sara and Balcan, Baran and Thunström, Erik and Wolf, Axel and Peker, Yüksel}},
issn = {{1550-9389}},
keywords = {{Cardiovascular disease; Health-related quality of life; SF-36; Sleep apnea}},
language = {{eng}},
number = {{9}},
pages = {{1311--1320}},
publisher = {{American Academy of Sleep Medicine}},
series = {{Journal of Clinical Sleep Medicine (JCSM)}},
title = {{CPAP and health-related quality of life in adults with coronary artery disease and nonsleepy obstructive sleep apnea in the RICCADSA trial}},
url = {{http://dx.doi.org/10.5664/jcsm.7926}},
doi = {{10.5664/jcsm.7926}},
volume = {{15}},
year = {{2019}},
}