ACCIDENTS IN OBSTRUCTIVE SLEEP-APNEA PATIENTS TREATED WITH NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE - A PROSPECTIVE-STUDY

Many studies have shown a relationship between obstructive sleep apnea (OSA) and accidents, hut to our knowledge, none have investigated pro spectively the effects of treatment with nasal continuous positive air way pressure (CPAP). CPAP was proposed to 973 patients, of whom 893 pa tients actually underwent CPAP. These patients were consecutively invi ted to enter a prospective follow-up study including a questionnaire b efore treatment and after 6 and 12 months of treatment; 547 patients c ompleted the study (153 left the study, and only partial data were ava ilable for 193). The baseline questionnaire included questions concern ing accidents in the previous le months, asking whether patients had h ad an accident and, if so, whether they felt that the accident(s) were related to sleepiness, and whether the patients felt that they had ha d near-miss accidents due to sleepiness. The questionnaires at 6 and 1 2 months included the same questions referring to the previous 6 month s; the accidents reported on each follow-up questionnaire were cumulat ed and compared with the accidents during the 1-year period before tre atment. The number of patients having an accident decreased with treat ment for real accidents (from 60 to 36; p<0.01), as well as for near-m iss accidents (from 151 to 32; p<0.01). The average number of accident s per patient also decreased, for real accidents (6 am 1.6+/-1.3 to 1. 1+/-0.3; p<0.01) and for near-miss accidents (from 4.5+/-6.5 to 1.8+/- 1.4; p<0.01). The cost, in terms of days in hospital related to accide nts, decreased from 885 to 84 days. With caution due to the absence of a control group, it is suggested that treatment with CPAP decreases t he number of accidents occurring in OSA patients. This result may have important implications in the evaluation of the cost/benefit ratio wh en treating OSA patients.