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.
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.
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持续气道正压通气治疗对患有睡眠呼吸暂停的高心血管风险个体的健康相关生活质量和嗜睡的影响：最佳呼吸暂停干预研究 (BestAIR) 试验。
DOI：
10.1093/sleep/zsx040
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发表时间：
2017
期刊：
影响因子：
5.6
通讯作者：
BestAIRInvestigators
中科院分区：
文献类型：
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作者：
Zhao,YingY;Wang,Rui;Gleason,KevinJ;Lewis,EldrinF;Quan,StuartF;Toth,ClaudiaM;Morrical,Michael;Rueschman,Michael;Weng,Jia;Ware,JamesH;Mittleman,MurrayA;Redline,Susan;BestAIRInvestigators
研究目的：持续气道正压通气（CPAP）对心血管疾病高危和阻塞性睡眠呼吸暂停（OSA）但无严重嗜睡的患者的健康相关生活质量（HRQOL）的长期影响尚不确定。我们的目的是确定在中度或重度OSA和心血管疾病（CVD）或多种CVD危险因素，没有严重sleeping.MethodsIn这个随机，对照，平行组研究，169名参与者被分配到治疗与CPAP或对照组（保守的药物治疗[CMT]或CMT与假CPAP）的个人的HRQOL CPAP治疗的效果。分析基于意向治疗方法。采用线性混合效应模型比较SF-36和主观嗜睡的变化（埃普沃思嗜睡量表[ESS]）从基线到6个月和12个月测量的平均值。结果CPAP改善了HRQOL的几个领域，包括身体疼痛（治疗效应9.7 [95%置信区间，CI 3.9 - 15.4]; p = .001），活力（5.7 [95% CI 1.5 - 9.9]; p = .008），一般健康状况（8.2 [95% CI 3.7 - 12.7]; p < .001），身体功能（5.5 [95% CI 1.1至10.0]; p = .016）和身体健康总分（3.3 [95% CI 1.4至5.3]; p = .001）。CPAP还导致日间嗜睡减少（ESS平均变化为-1.0点[95%CI-2.0 to-0.0]; p = 0.040）. Conclusions在心血管事件高风险且无严重嗜睡的中重度OSA患者中，CPAP在6至12个月的随访中改善了日间嗜睡和HRQOL的多个领域，观察到身体疼痛的最大改善。
Study ObjectivesThe long-term effect of continuous positive airway pressure (CPAP) on health-related quality of life (HRQOL) in patients with high cardiovascular disease risk and obstructive sleep apnea (OSA) without severe sleepiness is uncertain. We aimed to determine the effect of CPAP treatment on HRQOL in individuals with moderate or severe OSA and cardiovascular disease (CVD) or multiple CVD risk factors without severe sleepiness.MethodsIn this randomized, controlled, parallel group study, 169 participants were assigned to treatment with CPAP or the control group (conservative medical therapy [CMT] or CMT with sham CPAP). Analyses were based on an intention-to-treat approach. Linear mixed effect models were fitted to compare the changes in the Medical Outcomes Study Short Form-36 (SF-36) and in subjective sleepiness (Epworth Sleepiness Scale [ESS]) between groups from baseline to the average of 6- and 12-month measurements.ResultsCPAP improved several domains of HRQOL including bodily pain (treatment effect 9.7 [95% confidence interval, CI 3.9 to 15.4]; p = .001), vitality (5.7 [95% CI 1.5 to 9.9]; p = .008), general health (8.2 [95% CI 3.7 to 12.7]; p < .001), physical functioning (5.5 [95% CI 1.1 to 10.0]; p = .016), and the physical health summary score (3.3 [95% CI 1.4 to 5.3]; p = .001). CPAP also resulted in less daytime sleepiness (mean change in ESS −1.0 point [95% CI −2.0 to −0.0]; p = .040).ConclusionsIn patients with moderate–severe OSA at high risk of cardiovascular events and without severe sleepiness, CPAP improved daytime sleepiness and multiple domains of HRQOL over 6 to 12 months of follow-up, with the largest improvement observed for bodily pain.