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Erschienen in: Sleep and Breathing 2/2020

15.07.2019 | Sleep Breathing Physiology and Disorders • Original Article

OSA and CPAP therapy: effect of gender, somnolence, and treatment adherence on health-related quality of life

verfasst von: Anna Lo Bue, Adriana Salvaggio, Serena Iacono Isidoro, Salvatore Romano, Giuseppe Insalaco

Erschienen in: Sleep and Breathing | Ausgabe 2/2020

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Abstract

Background

Obstructive sleep apnea (OSA) often has a significant impact on health-related quality of life (HRQoL) with social and psychological implications. For most OSA patients, a reduction in their HRQoL is due to symptoms such as poor sleep quality, excessive daytime somnolence, and fatigue with differences between gender.

Purpose

This study explores the CPAP treatment effect on self-perceived HRQoL related to gender, somnolence, and CPAP adherence.

Methods

Out of 1082 consecutive Italian outpatients, 125 (82 M) (60.3 ± 9.6 years) completed the prospective observational study and were evaluated at the first visit (T0), and the follow-up visit (T1). Two self-reported HRQoL questionnaires were administered: six subscales Psychological General Well-Being Index (PGWBI) and 12-Item Short-Form Health Survey (SF-12).

Results

Scores of PGWBI and SF-12 MCS improved from T0 to T1. Patients with CPAP use ≥ 4 h/night showed a significant improvement in all dimensions evaluated, except for SF-12 PCS. At T1, participants with ESS > 10 improved in all scores, except SF-12 PCS. Gender comparison shows better-perceived HRQoL in males at first visit and CPAP follow-up visit. Variation of PGWBI was significantly correlated with CPAP use, ESS at T0 and T1 (p < 0.0001; r2 = 0.26).

Conclusions

This study provides evidence on the effectiveness of CPAP treatment on perceived HRQoL. Participants with greater adherence to therapy, greater sleepiness, and greater improvement of daytime sleepiness with CPAP therapy, reported a higher quality of life improvement. Gender comparison shows better-perceived HRQoL in males at first visit and CPAP follow-up, despite a more considerable improvement in females.
Literatur
1.
Zurück zum Zitat Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–1239CrossRef Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–1239CrossRef
2.
Zurück zum Zitat Lee W, Lee SA, Ryu HU, Chung YS, Kim WS (2016) Quality of life in patients with obstructive sleep apnea: relationship with daytime sleepiness, sleep quality, depression, and apnea severity. Chron Respir Dis 13:33–39CrossRef Lee W, Lee SA, Ryu HU, Chung YS, Kim WS (2016) Quality of life in patients with obstructive sleep apnea: relationship with daytime sleepiness, sleep quality, depression, and apnea severity. Chron Respir Dis 13:33–39CrossRef
3.
Zurück zum Zitat Epstein LJ, Kristo D, Strollo PJ Jr et al (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5:263–726CrossRef Epstein LJ, Kristo D, Strollo PJ Jr et al (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5:263–726CrossRef
4.
Zurück zum Zitat Diamanti C, Manali E, Ginieri-Coccossis M, Vougas K, Cholidou K, Markozannes E, Bakakos P, Liappas I, Alchanatis M (2013) Depression, physical activity, energy consumption, and quality of life in OSA patients before and after CPAP treatment. Sleep Breath 17:1159–1168CrossRef Diamanti C, Manali E, Ginieri-Coccossis M, Vougas K, Cholidou K, Markozannes E, Bakakos P, Liappas I, Alchanatis M (2013) Depression, physical activity, energy consumption, and quality of life in OSA patients before and after CPAP treatment. Sleep Breath 17:1159–1168CrossRef
5.
Zurück zum Zitat Sawyer AM, Gooneratne NS, Marcus CL, Ofer D, Richards KC, Weaver TE (2011) A systematic review of CPAP adherence across age groups: clinical and empiric insights for developing CPAP adherence interventions. Sleep Med Rev 15:343–356CrossRef Sawyer AM, Gooneratne NS, Marcus CL, Ofer D, Richards KC, Weaver TE (2011) A systematic review of CPAP adherence across age groups: clinical and empiric insights for developing CPAP adherence interventions. Sleep Med Rev 15:343–356CrossRef
6.
Zurück zum Zitat Luyster FS, Dunbar-Jacob J, Aloia MS, Martire LM, Buysse DJ, Strollo PJ (2016) Patient and partner experiences with obstructive sleep apnea and CPAP treatment: a qualitative analysis. Behav Sleep Med 14:67–84CrossRef Luyster FS, Dunbar-Jacob J, Aloia MS, Martire LM, Buysse DJ, Strollo PJ (2016) Patient and partner experiences with obstructive sleep apnea and CPAP treatment: a qualitative analysis. Behav Sleep Med 14:67–84CrossRef
7.
Zurück zum Zitat Iacono Isidoro S, Salvaggio A, Lo Bue A, Romano S, Marrone O, Insalaco G (2013) Quality of life in patients at first time visit for sleep disorders of breathing at a sleep Centre. Health Qual Life Outcomes 11:207CrossRef Iacono Isidoro S, Salvaggio A, Lo Bue A, Romano S, Marrone O, Insalaco G (2013) Quality of life in patients at first time visit for sleep disorders of breathing at a sleep Centre. Health Qual Life Outcomes 11:207CrossRef
8.
Zurück zum Zitat Iacono Isidoro S, Salvaggio A, Lo Bue A, Romano S, Marrone O, Insalaco G (2015) Effect of obstructive sleep apnea diagnosis on health related quality of life. Health Qual Life Outcomes 13:68CrossRef Iacono Isidoro S, Salvaggio A, Lo Bue A, Romano S, Marrone O, Insalaco G (2015) Effect of obstructive sleep apnea diagnosis on health related quality of life. Health Qual Life Outcomes 13:68CrossRef
9.
Zurück zum Zitat Iacono Isidoro S, Salvaggio A, Lo Bue A, Romano S, Marrone O, Insalaco G (2016) Immediate effect of CPAP titration on perceived health related quality of life: a prospective observational study. BMC Pulm Med 16:172CrossRef Iacono Isidoro S, Salvaggio A, Lo Bue A, Romano S, Marrone O, Insalaco G (2016) Immediate effect of CPAP titration on perceived health related quality of life: a prospective observational study. BMC Pulm Med 16:172CrossRef
10.
Zurück zum Zitat Basoglu OK, Tasbakan MS (2017) Gender differences in clinical and polysomnographic features of obstructive sleep apnea: a clinical study of 2827 patients. Sleep Breath 20:1–9 Basoglu OK, Tasbakan MS (2017) Gender differences in clinical and polysomnographic features of obstructive sleep apnea: a clinical study of 2827 patients. Sleep Breath 20:1–9
11.
Zurück zum Zitat Ye L, Pien GW, Weaver TE (2009) Gender differences in clinical manifestations of obstructive sleep apnea. Sleep Med 10:1075–1084CrossRef Ye L, Pien GW, Weaver TE (2009) Gender differences in clinical manifestations of obstructive sleep apnea. Sleep Med 10:1075–1084CrossRef
12.
Zurück zum Zitat Young T, Peppard PE (2005) Clinical presentation of OSAS: gender does matter. Sleep 28:293–295PubMed Young T, Peppard PE (2005) Clinical presentation of OSAS: gender does matter. Sleep 28:293–295PubMed
13.
Zurück zum Zitat Gottlieb DJ, Whitney CW, Bonekat WH et al (1999) Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study. Am J Respir Crit Care Med 159:502–507CrossRef Gottlieb DJ, Whitney CW, Bonekat WH et al (1999) Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study. Am J Respir Crit Care Med 159:502–507CrossRef
14.
Zurück zum Zitat Jacobsen JH, Shi L, Mokhlesi B (2013) Factors associated with excessive daytime sleepiness in patients with severe obstructive sleep apnea. Sleep Breath 17:629–635CrossRef Jacobsen JH, Shi L, Mokhlesi B (2013) Factors associated with excessive daytime sleepiness in patients with severe obstructive sleep apnea. Sleep Breath 17:629–635CrossRef
15.
Zurück zum Zitat Aurora RN, Collop NA, Jacobowitz O, Thomas SM, Quan SF, Aronsky AJ (2015) Quality measures for the care of adult patients with obstructive sleep apnea. J Clin Sleep Med 11:357–383CrossRef Aurora RN, Collop NA, Jacobowitz O, Thomas SM, Quan SF, Aronsky AJ (2015) Quality measures for the care of adult patients with obstructive sleep apnea. J Clin Sleep Med 11:357–383CrossRef
16.
Zurück zum Zitat Ye L, Pien G, Ratcliffe SJ, Weaver TE (2009) Gender differences in obstructive sleep apnea and treatment response to continuous positive airway pressure. J Clin Sleep Med 5:512–518CrossRef Ye L, Pien G, Ratcliffe SJ, Weaver TE (2009) Gender differences in obstructive sleep apnea and treatment response to continuous positive airway pressure. J Clin Sleep Med 5:512–518CrossRef
18.
Zurück zum Zitat Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson Ward SL, Tangredi MM, American Academy of Sleep Medicine (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 8:597–619CrossRef Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson Ward SL, Tangredi MM, American Academy of Sleep Medicine (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 8:597–619CrossRef
19.
Zurück zum Zitat Grossi E, Mosconi P, Groth N, Niero M, Apolone G (2002) Il Questionario psychological general well being, Questionario per la valutazione dello stato generale di benessere psicologico. Versione Italiana. Istituto di Ricerche Farmacologiche Mario Negri, Milan Grossi E, Mosconi P, Groth N, Niero M, Apolone G (2002) Il Questionario psychological general well being, Questionario per la valutazione dello stato generale di benessere psicologico. Versione Italiana. Istituto di Ricerche Farmacologiche Mario Negri, Milan
20.
Zurück zum Zitat Dupuy H (1984) The psychological general well-being (PGWB) index. In: Wenger NK, Mattson ME, Furburg CD, Elinson J (eds) Assessment of quality of life in clinical trials of cardiovascular therapies. Le Jacq Publishing, New York, pp 170–183 Dupuy H (1984) The psychological general well-being (PGWB) index. In: Wenger NK, Mattson ME, Furburg CD, Elinson J (eds) Assessment of quality of life in clinical trials of cardiovascular therapies. Le Jacq Publishing, New York, pp 170–183
21.
Zurück zum Zitat Apolone G, Mosconi P, Quattrociocchi L, Gianicolo EA, Groth N, Ware JE (2005) Questionario sullo Stato di Salute SF-12. Versione italiana. Istituto di Ricerche Farmacologiche Mario Negri, Milan Apolone G, Mosconi P, Quattrociocchi L, Gianicolo EA, Groth N, Ware JE (2005) Questionario sullo Stato di Salute SF-12. Versione italiana. Istituto di Ricerche Farmacologiche Mario Negri, Milan
22.
Zurück zum Zitat Kodraliu G, Mosconi P, Groth N et al (2001) Subjective health status assessment: evaluation of the Italian version of the SF-12 short-form health survey. Results from the MiOS Project construction of scales and preliminary tests of reliability and validity. J Epidemiol Biostat 6:305–316CrossRef Kodraliu G, Mosconi P, Groth N et al (2001) Subjective health status assessment: evaluation of the Italian version of the SF-12 short-form health survey. Results from the MiOS Project construction of scales and preliminary tests of reliability and validity. J Epidemiol Biostat 6:305–316CrossRef
23.
Zurück zum Zitat Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545CrossRef Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545CrossRef
24.
Zurück zum Zitat Vignatelli L, Plazzi G, Barbato A, Ferini-Strambi L, Manni R, Pompei F, D'Alessandro R, GINSEN (Gruppo Italiano Narcolessia Studio Epidemiologico Nazionale (2003) Italian version of the Epworth sleepiness scale: external validity. Neurol Sci 23:295–300CrossRef Vignatelli L, Plazzi G, Barbato A, Ferini-Strambi L, Manni R, Pompei F, D'Alessandro R, GINSEN (Gruppo Italiano Narcolessia Studio Epidemiologico Nazionale (2003) Italian version of the Epworth sleepiness scale: external validity. Neurol Sci 23:295–300CrossRef
25.
Zurück zum Zitat Kuna ST, Gurubhagavatula I, Maislin G, Hin S, Hartwig KC, McCloskey S, Hachadoorian R, Hurley S, Gupta R, Staley B, Atwood CW (2011) Noninferiority of functional outcome in ambulatory management of obstructive sleep apnea. Am J Respir Crit Care Med 183:1238–1244CrossRef Kuna ST, Gurubhagavatula I, Maislin G, Hin S, Hartwig KC, McCloskey S, Hachadoorian R, Hurley S, Gupta R, Staley B, Atwood CW (2011) Noninferiority of functional outcome in ambulatory management of obstructive sleep apnea. Am J Respir Crit Care Med 183:1238–1244CrossRef
26.
Zurück zum Zitat Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Erlbaum Associates, Mahwah Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Erlbaum Associates, Mahwah
27.
Zurück zum Zitat Cairns A, Poulos G, Bogan R (2016) Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing. Nat Sci Sleep 8:197–205CrossRef Cairns A, Poulos G, Bogan R (2016) Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing. Nat Sci Sleep 8:197–205CrossRef
28.
Zurück zum Zitat Barsky AJ, Peekna HM, Borus JF (2001) Somatic symptom reporting in women and men. J Gen Intern Med 16:266–275CrossRef Barsky AJ, Peekna HM, Borus JF (2001) Somatic symptom reporting in women and men. J Gen Intern Med 16:266–275CrossRef
29.
Zurück zum Zitat Sforza E, de Saint Hilaire Z, Pelissolo A, Rochat T, Ibanez V (2002) Personality, anxiety and mood traits in patients with sleep-related breathing disorders: effect of reduced daytime alertness. Sleep Med 3:139–145CrossRef Sforza E, de Saint Hilaire Z, Pelissolo A, Rochat T, Ibanez V (2002) Personality, anxiety and mood traits in patients with sleep-related breathing disorders: effect of reduced daytime alertness. Sleep Med 3:139–145CrossRef
30.
Zurück zum Zitat Kang JM, Kang SG, Cho SJ, Lee YJ, Lee HJ, Kim JE, Shin SH, Park KH, Kim ST (2017) The quality of life of suspected obstructive sleep apnea patients is related to their subjective sleep quality rather than the apnea-hypopnea index. Sleep Breath 21:369–375CrossRef Kang JM, Kang SG, Cho SJ, Lee YJ, Lee HJ, Kim JE, Shin SH, Park KH, Kim ST (2017) The quality of life of suspected obstructive sleep apnea patients is related to their subjective sleep quality rather than the apnea-hypopnea index. Sleep Breath 21:369–375CrossRef
31.
Zurück zum Zitat Billings ME, Rosen CL, Auckley D, Benca R, Foldvary-Schaefer N, Iber C, Zee PC, Redline S, Kapur VK (2014) Psychometric performance and responsiveness of the functional outcomes of sleep questionnaire and sleep apnea quality of life instrument in a randomized trial: the HomePAP study. Sleep 37:2017–2024CrossRef Billings ME, Rosen CL, Auckley D, Benca R, Foldvary-Schaefer N, Iber C, Zee PC, Redline S, Kapur VK (2014) Psychometric performance and responsiveness of the functional outcomes of sleep questionnaire and sleep apnea quality of life instrument in a randomized trial: the HomePAP study. Sleep 37:2017–2024CrossRef
33.
Zurück zum Zitat Baldwin CM, Kapur VK, Holberg CJ, Rosen C, Nieto FJ (2004) Associations between gender and measures of daytime somnolence in the sleep heart health study. Sleep 27:305–311CrossRef Baldwin CM, Kapur VK, Holberg CJ, Rosen C, Nieto FJ (2004) Associations between gender and measures of daytime somnolence in the sleep heart health study. Sleep 27:305–311CrossRef
34.
Zurück zum Zitat Silva GE, Goodwin JL, Vana KD, Quan SF (2016) Obstructive sleep apnea and quality of life: comparison of the SAQLI, FOSQ, and SF-36 questionnaires. Southwest J Pulm Crit Care 13:137–149CrossRef Silva GE, Goodwin JL, Vana KD, Quan SF (2016) Obstructive sleep apnea and quality of life: comparison of the SAQLI, FOSQ, and SF-36 questionnaires. Southwest J Pulm Crit Care 13:137–149CrossRef
35.
Zurück zum Zitat Weaver TE, Maislin G, Dinges DF, Bloxham T, George CFP, Greenberg H, Kader G, Mahowald M, Younger J, Pack AI (2007) Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep 30:711–719CrossRef Weaver TE, Maislin G, Dinges DF, Bloxham T, George CFP, Greenberg H, Kader G, Mahowald M, Younger J, Pack AI (2007) Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep 30:711–719CrossRef
36.
Zurück zum Zitat Avlonitou E, Kapsimalis F, Varouchakis G, Vardavas CI, Behrakis P (2012) Adherence to CPAP therapy improves quality of life and reduces symptoms among sleep apnea syndrome patients. Sleep Breath 16:563–569CrossRef Avlonitou E, Kapsimalis F, Varouchakis G, Vardavas CI, Behrakis P (2012) Adherence to CPAP therapy improves quality of life and reduces symptoms among sleep apnea syndrome patients. Sleep Breath 16:563–569CrossRef
37.
Zurück zum Zitat Olsen S, Smith S, Oei TP (2008) Adherence to continuous positive airway pressure therapy in obstructive sleep apnoea sufferers: a theoretical approach to treatment adherence and intervention. Clin Psychol Rev 28:1355–1371CrossRef Olsen S, Smith S, Oei TP (2008) Adherence to continuous positive airway pressure therapy in obstructive sleep apnoea sufferers: a theoretical approach to treatment adherence and intervention. Clin Psychol Rev 28:1355–1371CrossRef
38.
Zurück zum Zitat Zhao YY, Wang R, Gleason KJ, BestAIR Investigators et al (2017) Effect of continuous positive airway pressure treatment on health-related quality of life and sleepiness in high cardiovascular risk individuals with sleep apnea: best apnea interventions for research (BestAIR) trial. Sleep 40:40. https://doi.org/10.1093/sleep/zsx040 CrossRef Zhao YY, Wang R, Gleason KJ, BestAIR Investigators et al (2017) Effect of continuous positive airway pressure treatment on health-related quality of life and sleepiness in high cardiovascular risk individuals with sleep apnea: best apnea interventions for research (BestAIR) trial. Sleep 40:40. https://​doi.​org/​10.​1093/​sleep/​zsx040 CrossRef
39.
Zurück zum Zitat Antic NA, Catcheside P, Buchan C, Hensley M, Naughton MT, Rowland S, Williamson B, Windler S, McEvoy RD (2011) The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA. Sleep 34:111–119CrossRef Antic NA, Catcheside P, Buchan C, Hensley M, Naughton MT, Rowland S, Williamson B, Windler S, McEvoy RD (2011) The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA. Sleep 34:111–119CrossRef
40.
Zurück zum Zitat Bjornsdottir E, Keenan BT, Eysteinsdottir B, Arnardottir ES, Janson C, Gislason T, Sigurdsson JF, Kuna ST, Pack AI, Benediktsdottir B (2015) Quality of life among untreated sleep apnea patients compared with the general population and changes after treatment with positive airway pressure. J Sleep Res 24:328–338CrossRef Bjornsdottir E, Keenan BT, Eysteinsdottir B, Arnardottir ES, Janson C, Gislason T, Sigurdsson JF, Kuna ST, Pack AI, Benediktsdottir B (2015) Quality of life among untreated sleep apnea patients compared with the general population and changes after treatment with positive airway pressure. J Sleep Res 24:328–338CrossRef
41.
Zurück zum Zitat Gupta MA, Simpson FC, Lyons DC (2015) The effect of treating obstructive sleep apnea with positive airway pressure on depression and other subjective symptoms: a systematic review and meta-analysis. Sleep Med Rev 28:51–64 Gupta MA, Simpson FC, Lyons DC (2015) The effect of treating obstructive sleep apnea with positive airway pressure on depression and other subjective symptoms: a systematic review and meta-analysis. Sleep Med Rev 28:51–64
Metadaten
Titel
OSA and CPAP therapy: effect of gender, somnolence, and treatment adherence on health-related quality of life
verfasst von
Anna Lo Bue
Adriana Salvaggio
Serena Iacono Isidoro
Salvatore Romano
Giuseppe Insalaco
Publikationsdatum
15.07.2019
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 2/2020
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-019-01895-3

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