Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Oct 1;186(7):677-83.
doi: 10.1164/rccm.201202-0200OC. Epub 2012 Jul 26.

Continuous positive airway pressure treatment of sleepy patients with milder obstructive sleep apnea: results of the CPAP Apnea Trial North American Program (CATNAP) randomized clinical trial

Terri E Weaver  1 , Cristina Mancini, Greg Maislin, Jacqueline Cater, Bethany Staley, J Richard Landis, Kathleen A Ferguson, Charles F P George, David A Schulman, Harly Greenberg, David M Rapoport, Joyce A Walsleben, Teofilo Lee-Chiong, Indira Gurubhagavatula, Samuel T Kuna
Affiliations
Randomized Controlled Trial

Continuous positive airway pressure treatment of sleepy patients with milder obstructive sleep apnea: results of the CPAP Apnea Trial North American Program (CATNAP) randomized clinical trial

Terri E Weaver et al. Am J Respir Crit Care Med. .

Abstract

Rationale: Twenty-eight percent of people with mild to moderate obstructive sleep apnea experience daytime sleepiness, which interferes with daily functioning. It remains unclear whether treatment with continuous positive airway pressure improves daytime function in these patients.

Objectives: To evaluate the efficacy of continuous positive airway pressure treatment to improve functional status in sleepy patients with mild and moderate obstructive sleep apnea.

Methods: Patients with self-reported daytime sleepiness (Epworth Sleepiness Scale score >10) and an apnea-hypopnea index with 3% desaturation and from 5 to 30 events per hour were randomized to 8 weeks of active or sham continuous positive airway pressure treatment. After the 8-week intervention, participants in the sham arm received 8 weeks of active continuous positive airway pressure treatment.

Measurements and main results: The Total score on the Functional Outcomes of Sleep Questionnaire was the primary outcome measure. The adjusted mean change in the Total score after the first 8-week intervention was 0.89 for the active group (n = 113) and -0.06 for the placebo group (n = 110) (P = 0.006). The group difference in mean change corresponded to an effect size of 0.41 (95% confidence interval, 0.14-0.67). The mean (SD) improvement in Functional Outcomes of Sleep Questionnaire Total score from the beginning to the end of the crossover phase (n = 91) was 1.73 ± 2.50 (t[90] = 6.59; P < 0.00001) with an effect size of 0.69.

Conclusions: Continuous positive airway pressure treatment improves the functional outcome of sleepy patients with mild and moderate obstructive sleep apnea.

Trial registration: ClinicalTrials.gov NCT00127348.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flowchart of the study profile. Of the 385 participants screened and consented, 281 were randomized and 42 withdrew before any exposure to active or sham continuous positive airway pressure (CPAP). These unexposed participants, although randomized, were excluded from all analyses. There were 239 randomized and exposed participants (n = 121 active and n = 118 sham CPAP). CATNAP = CPAP Apnea Trial North American Program.
Figure 2.
Figure 2.
The mean (SD) Functional Outcomes of Sleep Questionnaire (FOSQ) Total score by treatment group in the primary efficacy cohort before and after the 8-week treatment period.
See this image and copyright information in PMC

Comment in

References

    1. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002;165:1217–1239 - PubMed
    1. Gottlieb DJ, Whitney CW, Bonekat WH, Iber C, James GD, Lebowitz M, Nieto FJ, Rosenberg CE. Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health study. Am J Respir Crit Care Med 1999;159:502–507 - PubMed
    1. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The report of an American Academy of Sleep Medicine task force. Sleep 1999;22:667–689 - PubMed
    1. Selim B, Won C, Yaggi HK. Cardiovascular consequences of sleep apnea. Clin Chest Med 2010;31:203–220 - PubMed
    1. Ellen RL, Marshall SC, Palayew M, Molnar FJ, Wilson KG, Man-Son-Hing M. Systematic review of motor vehicle crash risk in persons with sleep apnea. J Clin Sleep Med 2006;2:193–200 - PubMed

Publication types

Associated data