Sleep remains disturbed in obstructive sleep apnea patients treated with positive airway pressure: a three-month cohort study using continuous actigraphy

Publication date: Available online 16 August 2016
Source:Sleep Medicine
Author(s): Jon Tippin, Nazan Aksan, Jeffrey Dawson, Steven W. Anderson, Matthew Rizzo
ObjectiveSome patients with obstructive sleep apnea (OSA) remain sleepy despite positive airway pressure (PAP) therapy. The mechanisms by which this occurs are unclear but could include persistently disturbed sleep. The goal of this study was to explore the relationships between subjective sleepiness and actigraphic measures of sleep during the first three months of PAP treatment.MethodsWe enrolled 80 patients with OSA and 50 comparison subjects prior to treatment and observed them through three months of PAP therapy. PAP adherence and presence of residual respiratory events were determined from PAP machine downloads. Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), and actigraphic data were collected before and at monthly intervals after starting PAP.ResultsOSA subjects were sleepier and showed a greater degree of sleep disruption by actigraphy at baseline. After three months of PAP, only ESS and number of awakenings normalized, while wake after sleep onset (WASO) and sleep efficiency (SE) remained worse in OSA subjects. For OSA subjects, FOSQ improved but never reached the same level as comparison subjects. ESS and FOSQ improved slowly over the study period.ConclusionsAs a group, OSA patients show actigraphic evidence of persistently disturbed sleep and sleepiness related impairments in day-to-day function after three months of PAP therapy. Improvements in sleepiness evolve over months with more severely affected patients responding quicker. Persistent sleep disruption may partially explain residual sleepiness in some PAP adherent OSA patients.



from #SleepMedicine via xlomafota13 on Inoreader http://ift.tt/2b3sNzl
via IFTTT