COMMENTARY

Sleep Apnea: Is CPAP Just as Beneficial for Women as it is for Men?

Nicholas J. Gross, MD, PhD

Disclosures

July 05, 2017

Continuous Positive Airway Pressure Improves Quality of Life in Women With Obstructive Sleep Apnea. A Randomized Controlled Trial.

Campos-Rodriguez F, Queipo-Corona C, Carmona-Bernal C, et al
Am J Respir Crit Care Med. 2016;194:1286-1294

Background

It has long been known that men with obstructive sleep apnea (OSA) have daytime sleepiness, impaired quality of life, and impaired health status and that continuous positive airway pressure (CPAP) treatments can improve these symptoms.[1] Although OSA also occurs in females, it is significantly less common than in males; it is assumed that manifestations of OSA are similar to those typically seen in males and that CPAP would be as effective. Consequently, as a group, females with OSA have not been specifically studied for their response to CPAP. The present trial is the first to study the effect of continuous nocturnal CPAP in females with moderate to severe OSA.

Study Summary

In a controlled trial from Spain, 307 middle-aged women with moderate to severe OSA, with a mean Epworth Sleepiness Scale of 9.8 (out of a scale of 24) were randomly assigned to receive either CPAP therapy or conservative management for 3 months. The primary endpoint was the change in quality of life based on the Quebec Sleep Questionnaire (QSQ); other subjective outcomes were also studied.

The women who received CPAP experienced significantly better outcomes with respect to each of the five domains that compose the QSQ: hypersomnolence, diurnal symptoms, nocturnal symptoms, emotions, and social interactions. Those considered to have more severe OSA experienced an improvement in nocturnal symptoms that was significantly greater than for those with only moderately severe OSA. Otherwise, the women with moderate or severe OSA experienced similar degrees of improvement. However, the treatment group experienced improvements in all components of the QSQ as compared with the untreated group.

There was a significant positive correlation between hours of CPAP and improvement in each of the QSQ domains except the hypersomnolence domain, which nevertheless showed a trend in the direction of improvement.

Viewpoint

OSA differs between the sexes with respect to prevalence, severity, and clinical presentation. The results of this study showed that women receiving CPAP obtained a significant improvement in all quality -of -life domains as compared with the control group. Daytime sleepiness, mood state, and anxiety and depression were also improved. Clearly, CPAP should be considered in all females with OSA.

Abstract

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