Study findings published in the June 15, 2009 issue of the Journal of Clinical Sleep Medicine show that complaints of fatigue and tiredness in patients with obstructive sleep apnea (OSA) improved significantly with good adherence to continuous positive airway pressure (CPAP) therapy, suggesting that — like the symptom of excessive daytime sleepiness — these complaints are important symptoms of obstructive sleep apnea.
Results indicate that good adherence to CPAP therapy for an average of five or more hours per night resolved baseline complaints of fatigue in 45 of 80 participants (56 percent), tiredness in 56 of 96 participants (58 percent) and sleepiness in 48 of 72 participants (67 percent); improvement of each symptom was significantly better among CPAP-adherent participants than among inadequately treated subjects. A baseline complaint of lack of energy also was resolved in 47 of 100 participants with good CPAP adherence, but this improvement failed to reach statistical significance when compared with inadequately treated participants.
According to senior investigator Ronald D. Chervin, M.D., M.S., of the Michael S. Aldrich Sleep Disorders Laboratory in Ann Arbor, Mich., physicians should consider the possibility of obstructive sleep apnea as a treatable underlying cause not just for the complaint of sleepiness, but also for the chief complaints of fatigue, tiredness and lack of energy.
"We found that sleep apnea patients who used their CPAP regularly, in comparison to those who did not, had much greater success in reducing their fatigue, tiredness and sleepiness," he said. "This suggests that sleep apnea may be the cause of these symptoms, as it is a cause of sleepiness."
The study involved 313 OSA patients with an average age of 54.7 years; 178 (56.9 percent) were men. It compared 183 participants who reported using CPAP for an average of five or more hours per night with 96 subjects who either had no active treatment (55 subjects) or reported using CPAP for an average of less than five hours per night (41 subjects); 34 participants were excluded from the analysis because they received a treatment other than CPAP.
Compared with inadequately treated patients, participants who had good adherence to CPAP had a higher severity of obstructive sleep apnea at baseline and lower self-reported sleepiness at follow-up. Both before and after treatment, women reported a complaint of lack of energy statistically more often than men.
Obstructive sleep apnea is a sleep-related breathing disorder that involves a partial or complete cessation of breathing despite the body’s desire to breathe. Apneic events occurs when tissues in the airway relax during sleep, which then collapse and block the upper airway. The blockages lead to partial reductions (hypopneas) and complete pauses (apneas) in breathing that can produce abrupt reductions in blood oxygen saturation. Most people who have sleep apnea snore, but not everyone who has sleep apnea snores, and not everyone who snores has sleep apnea. An overnight polysomnogram (sleep study) can be used to determine if a person does have sleep apnea, how severe the apnea is, and how it should best be treated, such as CPAP, bi-level/BiPAP therapy, or a different approach.
The authors suggest that their findings are in agreement with previous research demonstrating that CPAP adherence is associated with improvements in obstructive sleep apnea symptoms, daytime sleepiness, cognitive impairments, blood pressure and quality of life.
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/Health — Fatigue/cpap-bipap-use-leads-to-well-rested-apneics/2009-06-21.1053
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