Validated Measures of Insomnia, Function, Sleepiness, and Nasal Obstruction in a CPAP Alternatives Clinic Population
- S-Med
- Jun 10
- 1 min read
Prior to the current study, there existed no analysis of the CPAP alternatives clinic patient population. These patients are at increased risk of potentially associated cardiovascular
complications—greater than 80% of this cohort demonstrated moderate to severe OSA with approximately half having co-morbid hypertension. The majority of patients in this cohort suffered from moderate to severe clinical insomnia and nasal obstruction, and approximately 90% demonstrated sleep-related functional impairment. Yet, most of these patients did not experience excessive daytime sleepiness. The majority of this
cohort, in need of OSA treatment, were able to receive recommendations during their initial visit. General demographics of this cohort, patients referred to a CPAP alternatives clinic, are relatively similar to other OSA cohorts. Interestingly, although all patients presented seeking alternatives to CPAP therapy, more than 30% of patients were using CPAP at the time of their encounter. Nearly all patients reported having previously attempted some form of OSA treatment, most frequently CPAP (95%). Recent investigation has indicated an association between CPAP non-adherence and non-obesity in OSA.20 In the current report, more than half of studied patients were non-obese (BMI < 30 kg/m2). It is postulated that up to 90% of these non-obese patients demonstrate low arousal thresholds for airway narrowing. G ray et al. hypothesize t hat low arousal threshold, characterizing these patients, contributes to frequent sleep
disruption that is exacerbated by CPAP masks and positive pressure.20 Clearly, this phenotype represents a challenging group to treat. Although CPAP remains the first-line therapy for most patients with OSA, it is reasonable to believe that patients such as these could benefit from therapy that does not increase arousals.
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