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Obstructive sleep apnea and self-reported functional impairment in revascularized patients with coronary artery disease in the RICCADSA trial

Baniak, Lynn M. ; Chasens, Eileen R. ; Luyster, Faith S. ; Strollo, Patrick J. ; Thunström, Erik and Peker, Yüksel LU (2018) In Sleep and Breathing 22(4). p.1169-1177
Abstract

Purpose: Daytime sleepiness, a frequent symptom of obstructive sleep apnea (OSA), can impact functional status. In patients with coronary artery disease (CAD) and concomitant OSA, the distinction between sleep-related functional impairment from underlying CAD versus OSA is unclear. This study evaluated the impact of OSA on sleep-related functional impairment in patients with CAD and compared the effect of 1-year continuous positive airway pressure (CPAP) use on change in impairment between those with and without excessive daytime sleepiness (EDS) and OSA. We hypothesized that sleep-related functional impairment is impacted by EDS independent of OSA in patients with CAD. Methods: One hundred five CAD patients without OSA and 105 with... (More)

Purpose: Daytime sleepiness, a frequent symptom of obstructive sleep apnea (OSA), can impact functional status. In patients with coronary artery disease (CAD) and concomitant OSA, the distinction between sleep-related functional impairment from underlying CAD versus OSA is unclear. This study evaluated the impact of OSA on sleep-related functional impairment in patients with CAD and compared the effect of 1-year continuous positive airway pressure (CPAP) use on change in impairment between those with and without excessive daytime sleepiness (EDS) and OSA. We hypothesized that sleep-related functional impairment is impacted by EDS independent of OSA in patients with CAD. Methods: One hundred five CAD patients without OSA and 105 with moderate-to-severe OSA from the RICCADSA trial were matched on disease severity and included in the current substudy. Of those with OSA, 80 were allocated to CPAP. Functional Outcomes of Sleep Questionnaire (FOSQ) score < 17.9 corresponded to sleep-related functional impairment. Results: Following revascularization, CAD patients with and without OSA frequently report sleep-related functional impairment (35% and 27.3%, respectively; p =.29). Moderate-to-severe OSA was not related to baseline FOSQ scores < 17.9 in regression analyses; EDS was (OR 4.82, 95% CI 2.12–11.0; p <.001). CPAP use significantly improved FOSQ scores from baseline to 1-year follow-up in OSA patients with EDS (17.2 ± 2.0 to 18.15 ± 1.7, p =.002) despite suboptimal adherence. Conclusions: Sleep-related functional impairment may be reflective of persistent EDS, independent of OSA. Diagnosing OSA and initiating treatment are worthwhile in individuals with CAD and EDS, as both are important to guide appropriate therapy in patients with CAD.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Continuous positive airway pressure, Coronary artery disease, Functional status, Obstructive sleep apnea
in
Sleep and Breathing
volume
22
issue
4
pages
1169 - 1177
publisher
Springer
external identifiers
  • pmid:30324547
  • scopus:85055522585
ISSN
1520-9512
DOI
10.1007/s11325-018-1733-4
language
English
LU publication?
yes
id
37c97ca5-b8c5-459a-a382-8de4d7f6ba89
date added to LUP
2018-12-07 13:29:35
date last changed
2020-07-01 04:53:00
@article{37c97ca5-b8c5-459a-a382-8de4d7f6ba89,
  abstract     = {<p>Purpose: Daytime sleepiness, a frequent symptom of obstructive sleep apnea (OSA), can impact functional status. In patients with coronary artery disease (CAD) and concomitant OSA, the distinction between sleep-related functional impairment from underlying CAD versus OSA is unclear. This study evaluated the impact of OSA on sleep-related functional impairment in patients with CAD and compared the effect of 1-year continuous positive airway pressure (CPAP) use on change in impairment between those with and without excessive daytime sleepiness (EDS) and OSA. We hypothesized that sleep-related functional impairment is impacted by EDS independent of OSA in patients with CAD. Methods: One hundred five CAD patients without OSA and 105 with moderate-to-severe OSA from the RICCADSA trial were matched on disease severity and included in the current substudy. Of those with OSA, 80 were allocated to CPAP. Functional Outcomes of Sleep Questionnaire (FOSQ) score &lt; 17.9 corresponded to sleep-related functional impairment. Results: Following revascularization, CAD patients with and without OSA frequently report sleep-related functional impairment (35% and 27.3%, respectively; p =.29). Moderate-to-severe OSA was not related to baseline FOSQ scores &lt; 17.9 in regression analyses; EDS was (OR 4.82, 95% CI 2.12–11.0; p &lt;.001). CPAP use significantly improved FOSQ scores from baseline to 1-year follow-up in OSA patients with EDS (17.2 ± 2.0 to 18.15 ± 1.7, p =.002) despite suboptimal adherence. Conclusions: Sleep-related functional impairment may be reflective of persistent EDS, independent of OSA. Diagnosing OSA and initiating treatment are worthwhile in individuals with CAD and EDS, as both are important to guide appropriate therapy in patients with CAD.</p>},
  author       = {Baniak, Lynn M. and Chasens, Eileen R. and Luyster, Faith S. and Strollo, Patrick J. and Thunström, Erik and Peker, Yüksel},
  issn         = {1520-9512},
  language     = {eng},
  number       = {4},
  pages        = {1169--1177},
  publisher    = {Springer},
  series       = {Sleep and Breathing},
  title        = {Obstructive sleep apnea and self-reported functional impairment in revascularized patients with coronary artery disease in the RICCADSA trial},
  url          = {http://dx.doi.org/10.1007/s11325-018-1733-4},
  doi          = {10.1007/s11325-018-1733-4},
  volume       = {22},
  year         = {2018},
}