Obstructive sleep apnea (OSA) in elderly patients. Role of continuos positive airway pressure (CPAP) treatment. A multicenter randomized controlled clinical trial

OBJECTIVE: To analyze the effect of CPAP treatment on various clinical variables, Quebec sleep questionnaire(QSQ),and neurocognitive tests in elderly patients who have a severe OSA (AHI≥30) . METHODS: A multicenter, randomized, controlled, clinical trial in a consecutive cohort of patients ≥ 70 years old with severe OSA to receive or not receive CPAP. Anthropometric data , clinical records, OSA related clinical symptoms, QSQ, neurocognitive, anxiety and depression ( HADS) tests were collected. Patients were monitored 3 times during the study, including variable measurements at the beginning and at 3 months. It was felt that there was good adherence to. The intragroup and intergroup comparison was performed jointly using an ANCOVA test on an intention to treat analysis (ITT). RESULTS: We randomized 214/285 elderly patients (105 CPAP and 109 not CPAP). There were no significant differences between baseline variables of the randomized groups. Mean age was 76 (4) years, 69% were men. The mean AHI was 50 (15) and 38% presented daytime sleepiness. The average use of CPAP was 4.9 (2.5) hours, with 69% patients with good adherence (CPAP ≥ 4h/night). CPAP group achieves a greater improvement in all quality of life domains (p CONCLUSIONS: In elderly patients with severe OSA, CPAP treatment resulted in an improvement in quality of life, sleep-related symptoms, anxiety and depression indexes and some neurocognitive aspects.