SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science I. Sleep Disorders – Breathing
Results: 33 subjects are currently enrolled. One year follow-up information
is available for 14 patients: 4 with overlap syndrome and 10 with
OSA only. Patients with overlap syndrome were slightly older than those
with OSA alone (61.8 years vs. 55.7 years). At baseline, both group of
patients had similar weight (BMI 34.5kg/m2 vs. BMI 36.9kg/m2, respectively).
After 1 year, BMI remained unchanged in both groups (36.3
kg/m2 vs BMI 34 kg/m2, respectively). At baseline, the OSA patients
compared to patients with overlap syndrome had more severe apnea
(AHI 42 vs. 29.5) and reported similar sleepiness (ESS 11.3 vs.11). After
1 year of CPAP treatment, ESS improved in OSA group (ESS 7.8) and
remained unchanged in overlap group (11.7). After 12 months, mean adherence
was worse in the overlap group (53.2% vs. 72.6% nights use for
greater than 4 hours) and hence, there was no improvement in the ESS
score. As expected, at baseline respiratory-related quality of life measured
by SGRQ was better in the OSA only group vs. overlap syndrome
(18.5 in the 51.95, respectively). After 1 year of treatment, both groups
exhibited no change in SGRQ total symptom score 17.2 vs. 50.5 respectively.
Similarly, there was no change in overall health-related quality of
life measured by the SF -36 questionnaire.
Conclusion: Patients in overlap group had more EDS with lower
AHI. However their CPAP compliance was worse compared to OSA
only group. CPAP therapy does not result in significant improvement
in health-related QoL measured by SGRQ and SF36 questionnaires in
patients with overlap syndrome.
0410
CPAP USE AND CHANGE IN BLOOD PRESSURE IN
OBSTRUCTIVE SLEEP APNEA
Budhiraja R 1,2 , Luraschi C 2 , Alzoubaidi M 2 , Hannah C 1 , Koebnick J 1 ,
Roesch J 2 , Quan SF 1,2,3
1
Pulmonary, Critical Care and Sleep Medicine, Southern Arizona
Veterans Affairs HealthCare System, Tucson, AZ, USA, 2 Medicine,
University of Arizona, Tucson, AZ, USA, 3 Sleep Medicine, Harvard
Medical School, Boston, MA, USA
Introduction: Studies assessing effects of continuous positive airway
pressure (CPAP) therapy on blood pressure (BP) in obstructive sleep
apnea (OSA) have produced conflicting results.
Methods: We reviewed the charts of 316 patients with newly-diagnosed
OSA who were started on CPAP. Systolic BP (SBP), Diastolic
BP (DBP), Mean BP (MBP) and Body Mass Index (BMI) at the time
of CPAP initiation were compared to that obtained 1-66 (average 21)
months later. CPAP adherence (average daily CPAP use and usage index,
i.e. percentage of nights CPAP was used for >4 hours) was assessed
2-6 weeks after the CPAP therapy was initiated.
Results: The mean age of the 316 patients (297 men and 19 women) was
61.1±10.3 years (range 29-90 years). The mean initial SBP was 133±14
mm Hg, DBP was 78±10 mm Hg, MBP 96±10 mm Hg and BMI was
36.47±7.04 kg/m 2 . Paired t-test revealed small decreases in SBP (2mm
Hg, P=0.02), DBP (4mm Hg, P