Benefit of CPAP use in older people with obstructive sleep apnea

Here is a study about obstructive sleep apnea (OSA) treatment in elderly people. It was done in the UK over 12 months in those 65 years and older with OSA. Subjects were randomized to get CPAP treatment or no CPAP treatment. Those who did not get CPAP received advice on minimizing daytime sleepiness through sleep habits, napping, caffeine use, and weight loss. The main purpose of the study was to see if CPAP use reduced sleepiness levels and if CPAP is cost-effective.

Results showed that subjective sleepiness was reduced to a greater extent in those that received CPAP treatment. As expected, the reduction in sleepiness levels was greatest for those who started out with the highest sleepiness levels. CPAP use reduced healthcare usage, which offset the cost of the CPAP - the authors concluded that CPAP use is cost effective for older patients.

Other outcomes were measured as well. CPAP use did not improve cognitive function or blood pressure. CPAP did improve total cholesterol levels at 3 months, but not at 21 months. Night time urination, and home and driving accidents were not improved with CPAP use.

What is most interesting to me about this study is that CPAP improved sleepiness despite a low amount of CPAP use by the participants. Good CPAP usage is generally defined as using CPAP at least 4 hours per night on 7 out of 10 nights. In this study, usage was about 2 hours per night on average.

CPAP improves blood sugar control

I've blogged before about how patients with obstructive sleep apnea (OSA) are at increased risk of developing diabetes. I've also written about how treating OSA can improve blood sugar control in diabetics. Here is another study that demonstrates long term use of CPAP (5 years) is associated with better control of blood sugar in diabetics. The study also showed that long term use of CPAP was associated with lower blood pressure and improved quality of life. The study authors concluded that CPAP use is a cost-effective treatment option for OSA.