Adherence
CPAP therapy normalizes subjective daytime sleepiness (measured by ESS) in a dose-dependent manner, but fails to normalize objective vigilance (MWT) or quality of life (FOSQ) in a substantial proportion of patients even with optimal adherence.
If you have moderate to severe sleep apnea, using CPAP for at least 7 hours a night significantly improves how sleepy you feel during the day. However, do not assume you will feel 100% normal or have perfect energy levels just because you are using the machine correctly. About 1 in 5 to 1 in 3 users still have residual sleepiness or quality of life issues despite perfect adherence. If this happens to you, do not stop using the CPAP. Instead, consult your doctor to check for other causes of fatigue, such as depression, obesity, or other sleep disorders.
In patients with symptomatic moderate to severe OSA (i.e., apnea-hypopnea index > 30/h), we found a treatment dose-response effect for CPAP in terms of Epworth Sleepiness Scale scores (P < 0.001)... Forty percent of patients in this trial had an abnormal Epworth Sleepiness Scale score at the conclusion of the trial. In addition, we showed no dose-response effect with the Maintenance of Wakefulness Test... only 35% of all patients had normal FOSQ scores after treatment.
Why this rating
Multicenter randomized controlled trial with 174 participants, objective adherence monitoring, and standardized outcome measures.
Source
The Effect of CPAP in Normalizing Daytime Sleepiness, Quality of Life, and Neurocognitive Function in Patients with Moderate to Severe OSA
Nick A. Antic et al. · SLEEP · 2011
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