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Factors influencing the response of psychological symptoms to continuous positive airway pressure therapy

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Abstract

Purpose

To examine whether in obstructive sleep apnea (OSA) patients the degree of sleepiness, slow-wave sleep (SWS) loss, and hypoxia influence the response of psychological symptoms to continuous positive airway pressure (CPAP) therapy.

Methods

A prospectively planned cohort was assessed. Participants underwent full overnight polysomnography. All answered the Symptom Checklist-90-Revised (SCL-90) and the Epworth sleepiness scale (ESS). Only cases with an apnea-hypopnea index ≤60 events/h were 24 invited to participate. In an interview by telephone, after a follow-up period between 2 months and 1 year, patients informed whether they were in treatment with CPAP or remained voluntarily untreated. Subjects who accepted to participate answered for the second time the SCL-90 and the ESS. The baseline variables of interest were: (a) score of the ESS, (b) duration of SWS, and (c) time with arterial oxygen saturation below 90 %. The outcomes were the change in SCL-90 scores in all dimensions and indices of the questionnaire.

Results

A number of 73 patients, mostly men, were included. In uncontrolled analyses, CPAP-treated patients showed significant improvement at follow-up in 10 of the 13 SCL-90 scores. Comparing with the control group, only six scores were improved. Baseline sleepiness was the best predictor of SCL-90 improvement after CPAP treatment in the univariate analyses, and the only significant predictor of improvement in a multivariate regression model.

Conclusions

Sleepiness may supersede other factors that influence psychological improvement in CPAP-treated patients with severe OSA.

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Acknowledgments

This study was partly supported by Fundo de Incentivo à Pesquisa (FIPE), HosPital de Clínicas de Porto Alegre (HCPA, Brazil). Ms. Carissimi was the recipient of a grant provided by the Brazilian government agency Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). Ms. Fiori was the recipient of a grant provided by the Brazilian government agency National Counsel of Technological and Scientific Development (CNPq).

Conflicts of interest

Authors have reported no financial conflicts of interest regarding the subject of the present study. Dr. Martinez is the co-owner of a sleep medicine clinic.

Financial support

This study was partly supported by Fundo de Incentivo à Pesquisa (FIPE), Hospital de Clínicas de Porto Alegre (HCPA, Brazil).

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Authors and Affiliations

  1. Graduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Alicia Carissimi & Denis Martinez

  2. Cardiology Division, Hospital de Clínicas de Porto Alegre (HCPA), Ramiro Barcelos, 2350, CEP 90035-003, Porto Alegre, Rio Grande do Sul, Brazil

    Alicia Carissimi, Denis Martinez, Lenise J. Kim & Cintia Z. Fiori

  3. Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil

    Denis Martinez & Cintia Z. Fiori

Authors
  1. Alicia Carissimi
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  2. Denis Martinez
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  4. Cintia Z. Fiori
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Correspondence to Alicia Carissimi.

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Carissimi, A., Martinez, D., Kim, L.J. et al. Factors influencing the response of psychological symptoms to continuous positive airway pressure therapy. Sleep Breath 18, 499–507 (2014). https://doi.org/10.1007/s11325-013-0911-7

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  • DOI: https://doi.org/10.1007/s11325-013-0911-7

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