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Effect of continuous positive airway pressure versus supplemental oxygen on sleep quality in obstructive sleep apnea: a placebo-CPAP-controlled study.

AbstractSTUDY OBJECTIVE:
We investigated the short-term effectiveness of continuous positive airway pressure (CPAP) and oxygen in improving sleep quality in patients with obstructive sleep apnea (OSA).
DESIGN:
Randomized, double-blind, placebo-controlled, parallel study.
SETTING:
General Clinical Research Center at a university hospital.
PATIENTS:
Seventy-six patients with untreated OSA.
INTERVENTIONS:
Patients were randomly assigned to 1 of 3 treatments (CPAP, placebo-CPAP, or nocturnal oxygen at 3 L per minute) for 2 weeks. Sleep quality was assessed at baseline and after 1 and 14 days of therapy. Repeated-measures analysis of variance was used to evaluate treatment and time effects, and their interaction.
MEASUREMENTS AND RESULTS:
Sixty-three patients completed the protocol. When compared with placebo-CPAP and nocturnal oxygen, CPAP increased rapid eye movement (REM) sleep and significantly reduced stage 1 sleep and the number of stage shifts (p < or = .003). CPAP improved, to within normal limits, the apnea-hypopnea index, total arousal index, and mean oxyhemoglobin saturation (p < or = .001). The effects of CPAP were apparent during the first night of therapy. Oxygen improved only mean nocturnal saturation (p = .009). CPAP had no significant effect on stage 2 sleep or slow-wave sleep.
CONCLUSIONS:
CPAP was associated with an improvement in sleep quality in patients with OSA by consolidating sleep, reducing stage 1 sleep, and improving REM sleep. CPAP was effective in correcting the respiratory and arousal abnormalities of OSA. The effectiveness of supplemental oxygen was limited to oxyhemoglobin desaturation.
AuthorsJosé S Loredo, Sonia Ancoli-Israel, Eui-Joong Kim, Weon Jeong Lim, Joel E Dimsdale
JournalSleep (Sleep) Vol. 29 Issue 4 Pg. 564-71 (Apr 2006) ISSN: 0161-8105 [Print] United States
PMID16676791 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Oxygen
Topics
  • Arousal (physiology)
  • Continuous Positive Airway Pressure (methods)
  • Disorders of Excessive Somnolence (diagnosis, epidemiology)
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oxygen (therapeutic use)
  • Patient Compliance (statistics & numerical data)
  • Polysomnography
  • Severity of Illness Index
  • Sleep
  • Sleep Apnea, Obstructive (diagnosis, drug therapy, therapy)

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