Dados do Trabalho

Título

Impact of Obstructive Sleep Apnea Treatment on Sleep Health in Same-Bed Partners: The SLEEP PARTNERS Randomized Trial

Introdução

Previous evidence suggests that obstructive sleep apnea (OSA) is associated with impaired sleep quality in same-bed sleep partners (SBSP). However, it is unknown whether OSA and its treatment may have an impact on overall sleep health in SBSP.

Objetivo

To evaluate the impact of 3 months of OSA treatment on sleep health in SBSP.

Métodos

In this placebo-controlled trial (Clinicaltrials.gov: NCT03011294), we randomly assigned patients with moderate to severe OSA (apnea-hypopnea index ≥15 events/h) who had SBSP to receive continuous positive airway pressure (CPAP) or placebo (nasal strips). We excluded SBSP under OSA treatment or previous history of cardiovascular disease. At baseline and after 3-months of follow-up, SBSP underwent a clinical evaluation, sleep questionnaires (Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale), and objective sleep duration and fragmentation using a 1-week wrist actigraphy (Actiwatch 2™, Philips Respironics).

Resultados

Sixty-three patients with OSA and an equal number of SBSP were included in the final analysis (age: 48±10 years; 79% women). At baseline, we observed sleep health impairments in SBSP, including long sleep latency (38.2±26.5 minutes), sleep fragmentation (34.1±11.0 awakenings), short sleep duration (6.4±1.0 hours), and poor sleep quality (63%). Furthermore, 24% of SBSP presented moderate to severe OSA. Mean adherence to CPAP and nasal strips were 5.66±1.77 h/night and 93.1±12.6%, respectively. CPAP treatment promoted significant improvements in sleep quality (P=0.02), and excessive daytime sleepiness (P=0.01) in SBSP. Compared to placebo, 3-months of CPAP therapy revealed significant delta differences in wake after sleep onset (Δ:+7.36 minutes vs. Δ:-4.71 minutes, respectively, P=0.002) and the number of awakenings (Δ:+2.83 vs. Δ:-0.97, respectively, P=0.02). These results, along with the improvement in sleep quality, remained consistent after excluding SBSP with moderate to severe OSA (P<0.05 for all).

Conclusões

In SBSP of patients with moderate to severe OSA, 3-months of CPAP therapy promotes significant improvements on subjective and objective sleep health parameters. These findings highlight the broader benefits of CPAP therapy within shared sleeping environments.

Palavras -chave

Continuous positive airway pressure; sleep apnea, obstructive; spouses; sleep quality; sleep duration.