Outcome of CPAP treatment for obstructive sleep apnea

Abstract

Introduction: Sleep apnea is a chronic disruption of oxygen in the blood due to sleep-induced respiratory tract due to delay in upper respiratory tract. The prevalence of OSA is 4-10% in adult men and 2-6% in women. There is no data about prevalence of obstructive sleep apnea (OSA) and sleep related breathing disorders and their treatment in Mongolia. The first Sleep research center was established in 2018 at the General hospital for state special servants in Mongolia, which led to improve the diagnose and treatment of various sleep disorders, including obstructive sleep apnea. Moreover, at Sleep research center we introduced the evidence-based research regarding the CPAP treatment for OSA. Polysomnography (PSG) is essential for diagnosis of OSA and for measure the outcome of Continuous positive airway pressure (CPAP) treatment. The sleep questionnaires are also significant for analyze of OSA treatment. Our objective is to determine the risk factors and CPAP-treatment outcome of OSA patients. Material and methods: This hospital based cross sectional and cohort study was conducted in sleep center of General hospital for state special servants (GHSSS) in Mongolia. We investigated daytime sleepiness, neurobehavioral function in patients with mild and severe obstructive sleep apnea (OSA) and to assess the response to 45 days of treatment with CPAP. Before commencement of CPAP, and at the end of each 45 days’ treatment period, patients underwent and completed: The sleep study, Epworth Sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), Functional outcome of sleep questionnaire (FOSQ) and Short form health survey (SF36). Results: We collected all of 97 (55 males, 42 females) sleep study from 15th November, 2018 to 01th Sep, 2019. From 97, we diagnosed 42 obstructive sleep apnea patient (15 females, 27 male) with AHI above than 20/h. 20 patients (7 females, 13 male) from 42 OSA patients took CPAP treatment for 1.5 months. CPAP improved self-reported symptoms and of OSA, including snoring, restless sleep, daytime sleepiness, and sleep questionnaires including ESS, FOSQ. Mean ESS score was 20.65 (7.0), ten patients (50%) had an ESS score above 10, suggesting significant subjective daytime sleepiness. Conclusion: Almost half of Sleep disorders patients were with OSA. . Male to female ratio was 1.1:1. 41-60 years old man was 31% of OSA patients. CPAP improved self reported symptoms of OSA, including snoring, restless sleep, daytime sleepiness. A significant improvement was seen in the ESS score with CPAP. We found benefit of CPAP in every tests of neurobehavioral function, SF-36 (36-item Short Form Medical Outcomes Survey), sleep-specific (Functional Outcomes of Sleep Questionnaire). There is no significant effect in PSQI, and Quality of life questionnaires.