Effect of continuous positive airway pressure in very elderly with moderate-to-severe obstructive sleep apnea pooled results from two multicenter randomized controlled trials.

Autores de IIS La Fe

• 

  Miguel Ángel Martínez García

  Autor

• Grace Jacqueline Oscullo Yépez

  Autor

• Alberto García Ortega

  Autor

• José Daniel Gómez Olivas

  Autor

• Thais Carolina Beauperthuy Levy

  Autor

• Amina Bekki

  Autor

Participantes ajenos a IIS La Fe

• Ponce, S.
• Pastor, E.
• Orosa, B.
• Catalan, P.
• Martinez, A.
• Hernandez, L.
• Muriel, A.
• Chiner, E.
• Vigil, L.
• Carmona, C.
• Mayos, M.
• Gozal, D.

Grupos

• Neumología

  

  Leader

  Miguel Ángel Martínez García

Abstract

STUDY OBJECTIVE: There is very limited information about the effect of continuous positive airway pressure (CPAP) in the very elderly. Here we aimed to analysed the effect of CPAP on a clinical cohort of patients with obstructive sleep apnea (OSA) =80 years old. METHODS: Post-hoc pooled analysis of two open-label, multicenter clinical trials aimed to determine the effect of CPAP in a consecutive clinical cohort of elderly (=70 years old) with moderate-to-severe OSA (apnea-hipopnea index =15 events/hour) randomized to receive CPAP or no CPAP for three months. Those consecutive patients =80 years old were included in the study. The primary endpoint was the change in Epworth Sleepiness scale (ESS). Secondary outcomes included sleep-related symptoms, quality of life, neurocognitive and mood status as well as office blood pressure measurements. RESULTS: From the initial 369 randomized individuals with =70 years, 97 (26.3%) with =80 years old were included (47 in the CPAP group and 50 in the no-CPAP group). The mean (SD) age was 81.5 (2.4) years. Average use of CPAP was 4.3 (2.6) hours/night (53% with good adherence) Patients in the CPAP group significantly improved snoring and witnessed apneas as well as AHI (from 41.9 to 4.9 events/hour). However no clinical improvements were seen in ESS (-1.2 points, 95%CI, 0.2 to -2.6), any domain of QSQ, any neurocognitive test, OSA-related symptoms, depression/anxiety or blood pressure levels. CONCLUSIONS: The present study does not support the use of CPAP in very elderly patients with moderate-to-severe OSA.

Copyright © 2021 Elsevier B.V. All rights reserved.

Keywords

• CPAP; Neurocognitive; OSA; Obstructive sleep apnea; Quality of life; Very elderly