Obstructive rest apnea is a common...

Obstructive rest apnea is a common condition that is characterized by dint of recurrent obstruction of the upper airway during drowse The airway obstruction results in repetitive episodes of asphyxia and arousal. Patients with this condition complain of daytime sleepiness, reduc alertness, and decreased quality of life. Continuous positive airway influence (CPAP) treatment is the primary treatment for patients with obstructive nap apnea. CPAP prevents airway collapse, thereby allowing improved doze However, evidence has varied forward the effectiveness of CPAP in decreasing daytime sleepiness. Patel and associates administrationed meta-analyses of randomized, controlled trials to evaluate the consequence of CPAP treatment on daytime sleepiness in patients with obstructive slumber apnea.

The studies that were analyzed measured sleepiness using an eight-question validated subjective sleepiness scan (Epworth Sleepiness Scale [ESS]) or an objective sleepiness experiment such as the Multiple doze Latency Test (MSLT) or the Maintenance of Wakefulness touchstone (MWT). The quality of the 12 studies included in the final analysis varied considerably, with lack of double-blinding being the greatest in number common reason. The severity of lie in the grave apnea and the severity of subjective sleepiness also varied greatly among the studies.

The conclusions demonstrated that CPAP leads to a significant improvement in the subjective sleepiness ES score as well as in the objective sleepiness MSLT and MWT scores. The terminates were not related to form relative to sex nationality, mean age, or dead body mass index. The findings give an inkling of that CPAP may be more beneficial for reducing sleepiness in patients with inexorable obstructive sleep apnea than in those with mild be dead apnea. One reason may be that a certain patients with mild obstructive nap apnea have a concomitant be motionless disorder (periodic leg movements, chronic repose deprivation, occult narcolepsy, idiopathic hypersomnolence); CPAP may not have a great validity on daytime sleepiness in these patients.

The authors deduce that CPAP improves subjective and objective daytime sleepiness in patients who have obstructive nap apnea. Studies are needed to compare CPAP with other treatment options, including oral appliances, autotitrating devices, and upper airway surgery Studies also ne to better measure potential benefits in patients with milder obstructive be motionless apnea.

In an accompanying editorial, Babar and Quan note that the objective improvement in CPAP-treated patients is not entirely clear and that further studies are requireed in patients with mild disease. They remind readers that questions remain about the efficacy of nasal CPAP in patients with obstructive be motionless apnea.

Patel SR et al. Continuous positive airway squeezing therapy for treating sleepiness in a diverse population with obstructive repose apnea. Arch Intern Med March 10 2003;163:565-71; Babar SI, Quan SF Continuous positive airway crushing Placebo power, or does it really work? Arch Intern M March 10 2003;163: 519-20

COPYRIGHT 2003 American Academy of Family Physicians

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