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

摘要

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 (TO), and the follow-up visit (Tl). Two self-reported HRQoL questionnaires were administered: six subscales Psychological General Weil-Being Index (PGWBI) and 12-Item Short-Form Health Survey (SF-12). Results Scores of PGWBI and SF-12 MCS improved from TO to Tl. Patients with CPAP use >4 h/night showed a significant improvement in all dimensions evaluated, except for SF-12 PCS. At T1, participants with ES S > 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 TO and Tl (p < 0.0001; r~2 = 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.