The Effect On Quality Of Life Of Continuous Positive Airway Pressure In Patients With Obstructive Sleep Apnea Syndrome: A Meta-analysis

Background:continuous positive airway pressure(CPAP)is the standard treatment of the obstructive sleep apnea syndrome(OSAS)and has been proposed as the most effective treatment.But the effect of CPAP on quality of life(QOL)is still controversial.The aim of this study was to make a systemic review and analyze if CPAP has the best effect on QOL of OSAS.Methods:A literature search was performed to identify studies published between 1966 and 2007comparing values of CPAP with control.Weighted mean difference(WMD)was used to analyze the data.The pooled WMD was calculated by using a fixed or random-effect model.Result:The outcomes for 1,256 patients from 16 studies,of whom 656 patients underwent CPAP and 600 underwent control,were included.CPAP led to significant improvements in the Nottingham health profile part2 (WMD -1.657;95%CI -3.005,-0.308;P=0.016)but there was no difference in general QOL scores.Patients undergoing CPAP scored better in physical function(WMD 3.457;95%CI 0.144,6.771;P=0.041),Body pain(WMD 4.017; 95%CI-0.008,8.042;P=0.05),Energy vitality(WMD 6.984;95%CI0.557, 13.411;P=0.033)and Physical Component Summary(PCS)(WMD 2.040;95%CI 0.045,4.035;P=0.045)using the SF-36 tool and there was significant statistical heterogeneity between study design in the physical function, body pain,vitality,physical problems,emotional problems and mental health domains.Conclusions:The results of the present meta-analysis show that there was no difference in general QOL when comparing CPAP with control.CPAP may improve physical domains and vitality.Study designs and QOL questionnaire tools are important to capture and evaluate information efficiently.Maybe generic quality of life instruments is not adequate to detect important changes in quality of life in patients with OSAS.