Effectiveness of CPAP Treatment in Daytime Function in Sleep Apnea Syndrome A Randomized Controlled Study with an Optimized Placebo

Application of continuous positive airway pressure (CPAP) as the standard treatment for sleep apnea/hypopnea syndrome (SAHS) is a moot point. Studies on the effectiveness of this treatment have been challenged because of the lack of a suitable placebo. The recent description of a true placebo (sham CPAP) prompted us to conduct a randomized trial of CPAP or placebo to assess the effectiveness of CPAP in improving SAHS-related symptoms and daytime function in patients with moderate to severe SAHS. Forty-eight patients, stratified in four groups according to severity, were randomly allocated into two treatment groups (optimal and sham CPAP) for a 6-wk period. Of these, 45 completed follow-up (91% males; age: 54 ± 10 yr; body mass index [BMI]: 32 ± 6 kg/m2; apnea-hypopnea index [AHI]: 54 ± 19 events/h; and Epworth Sleepiness Scale [ESS]: 16 ± 5). The ESS, a questionnaire on SAHS-related symptoms, Functional Outcomes Sleep Questionnaire (FOSQ), and the Short Form Health Survey (SF-36) were completed at inclusi...