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CPAP and health-related quality of life in adults with coronary artery disease and nonsleepy obstructive sleep apnea in the RICCADSA trial

Wallström, Sara ; Balcan, Baran ; Thunström, Erik ; Wolf, Axel and Peker, Yüksel LU (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.

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author
organization
publishing date
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
2020-07-08 05:05:07
@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 &lt; 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 &lt; .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},
  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},
}