IMPROVEMENT OF MILD SLEEP-DISORDERED BREATHING WITH CPAP COMPARED WITH CONSERVATIVE THERAPY

The aim of this randomized controlled trial was to assess the effects of treatment with continuous positive airway pressure versus conservat ive therapy (CT) on well-being, mood, and functional status in subject s with mild sleep-disordered breathing (SDB). One hundred and eleven s ubjects, aged 25 to 65 yr, with a respiratory disturbance index (RDI) of 5 to 30 and without subjective pathologic sleepiness, were randomiz ed to nasal CPAP or to CT. Ninety-seven subjects were followed-up afte r 8 wk. Treatment response was assessed from changes between baseline and follow-up measures of mood, energy/fatigue, and functional status/ general health. Of the 51 subjects randomized to CPAP, 25 (49%) experi enced an improved outcome, as compared with 12 of 46 of subjects (26%) randomized to CT (p < 0.05). The odds of experiencing a treatment res ponse in the CPAP as compared with the Ci group were 2.72 (OR: 1.18 to 6.58, 95% CI). A beneficial effect of CPAP over CT was most evident a mong individuals without sinus problems and among subjects with hypert ension or diabetes. Differential treatment responses were not related to degree of baseline sleepiness or SDB. This suggests that middle-age d snorers with relatively low levels of SDB (RDI < 30) may benefit mor e from nasal CPAP than from less specific therapy directed at improvin g breathing during sleep. CPAP therapy may be beneficial to a broader group of subjects than previously appreciated.