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Observational Study
. 2021 Jan 11;22(1):61.
doi: 10.1186/s12891-020-03932-9.

Positive airway pressure therapy for obstructive sleep apnea in patients with Osteogenesis imperfecta: a prospective pilot study

Heidi Arponen  1   2 , Adel Bachour  3 , Leif Bäck  4 , Helena Valta  5   6 , Antti Mäkitie  4 , Outi Mäkitie  5   6   7   8 , Janna Waltimo-Sirén  9   10   11   12
Affiliations
Observational Study

Positive airway pressure therapy for obstructive sleep apnea in patients with Osteogenesis imperfecta: a prospective pilot study

Heidi Arponen et al. BMC Musculoskelet Disord. .

Abstract

Background: Obstructive sleep apnea (OSA) is prevalent in individuals with Osteogenesis imperfecta (OI). To date, no study has investigated treatment of OSA in adult individuals with OI using positive airway pressure (PAP). This observational pilot study examined the adherence of adults with OI to treatment of OSA with PAP therapy, and the evolution of self-experienced sleepiness and depression symptoms before and after treatment.

Methods: We included 20 patients, with a mean age of 51 years, who represented varying severity of OI and displayed an apnea and hypopnea index ≥ 5 /sleeping hour as recorded by an overnight polysomnography. PAP therapy was proposed to all patients. Epworth Sleepiness Scale (ESS) questionnaire to evaluate daytime sleepiness, and a validated self-rating depression questionnaire to identify possible depression, were completed prior to PAP therapy and repeated after a minimum of one year. The datasets supporting the conclusions of this article are included within the article.

Results: From the 20 patients, 15 initiated PAP therapy, and two patients later interrupted it. The mean PAP follow-up period was 1230 days. At baseline, an abnormally high ESS score was reported by 29% of the respondents, and an abnormally high number of symptoms suggesting depression by 29%. Follow-up questionnaires were completed by 60% of the patients, of whom 83% were adherent to PAP treatment. ESS score and depression symptoms did not decrease significantly with PAP therapy.

Conclusions: Patients with OI accepted well PAP therapy and remained compliant. Sleepiness and depression persisted unaltered despite good PAP adherence. These unexpectedly poor improvements in symptoms by PAP therapy may be due to subjective depression symptoms and the complexity of factors underlying persisting sleepiness in OI. Further research is needed to confirm this novel finding.

Keywords: Adherence; Depression; Fatigue; Osteogenesis imperfecta; PAP therapy; Sleep apnea; Sleepiness.

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Conflict of interest statement

The authors declare that they have no competing interests.

Heidi Arponen, Adel Bachour, Leif Bäck, Helena Valta, Antti Mäkitie, Outi Mäkitie, and Janna Waltimo-Sirén declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Patient flow diagram
Fig. 2
Fig. 2
Boxplot of Epworth Sleepiness Scales (ESS) and self-rating depression (DEPS) scores at baseline and after positive airway therapy (PAP) in adult Osteogenesis imperfecta patients with diagnosed sleep apnea
See this image and copyright information in PMC

References

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