Common treatment for sleep apnea may not benefit


image: David Gozal, MD, Marie M. and Harry L. Smith Chair in Child Health at the University of Montreal School of Medicine.
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Credit: Justin Kelley, MU Health Care

Continuous positive airway pressure (CPAP) is the treatment of choice for moderate to severe obstructive sleep apnea (OSA). But researchers from University of Missouri School of Medicine found that this treatment might not be as effective in patients over the age of 80.

Sleep apnea is a sleep disorder that causes people to repeatedly stop breathing during the night. If left untreated, it can lead to serious health problems, including high blood pressure, heart problems, and even depression or anxiety. CPAP machines treat sleep apnea by delivering airflow into a person’s airway through a mask and tube, preventing the airway from collapsing and allowing the person to breathe continuously for his sleep. Previous studies have shown that CPAP therapy can significantly reduce sleepiness and depression and protect against high blood pressure.

In this study, researchers studied 369 participants over the age of 70 with OSA and assigned about half of them to CPAP treatment for three months. The researchers used several measures to compare the two groups, including a subjective measure of a patient’s sleepiness, the effect of CPAP on sleep-related quality of life, the effect on anxiety and depression. and the impact on blood pressure levels. They then subdivided the results into the elderly and those under 80.

“Our results suggest that CPAP therapy is not as effective in patients over 80 with OSA as it is in younger patients,” said lead author David Gozal, MD, Marie Chair M. and Harry L. Smith Endowed Child Health at MU School of Medicine. “We found no improvement in OSA-related symptoms, quality of life parameters, mood-related symptoms, or blood pressure compared to the group that did not receive CPAP treatment.”

Gozal said patients over 80 generally have a more sedentary lifestyle and the presence of other disorders that can also affect the quality or quantity of sleep, but cannot be treated with CPAP. He also cited other previous studies that suggest patients over 80 are less likely to adhere to long-term CPAP therapy.

“Given the growing population of elderly patients referred for sleep consultation, large clinical trials are urgently needed to attempt to address key questions related to the use of CPAP in patients over the age of 75 or 80 years,” Gozal said. “These questions include: What type of elderly patient with OSA will benefit from CPAP? Is CPAP a cost-effective treatment for patients in this age group? And once CPAP treatment is started, should it last forever? ?”

In addition to Gozal, the study authors include several Spanish researchers, including co-lead author MA Martinez-Garcia, MD, PhD, head of the pulmonology section of the University Hospital and Politenico La Fe in Valencia.

their study, “Effect of Continuous Positive Airway Pressure in Very Old People with Moderate to Severe Obstructive Sleep Apnea, Pooled Results of Two Multicentre Randomized Controlled Trials”, just published in the journal Sleep medicine.

The authors disclose no conflict of interest.

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