Obstructive Sleep Apnea Clinical Trial
Official title:
Quality of Life in Patients With Obstructive Sleep Apnea: The Role of CPAP Associated to Psychological Support
Many researches have shown that patients with Obstructive Sleep Apnea (OSA) and often also
the family members have a decreased quality of life, problems related to the sexual sphere,
depressive disorders and anxiety problems. To date still remains controversial the
relationship between OSA and quality of life, also the link between sleep apnea syndrome and
depression is unclear.
In adult patients with OSA the treatment of choice is the application of a continuous
positive airway pressure (CPAP: Continuous Positive Airway Pressure) at the opening of the
airways. With the CPAP treatment the sleep normalizes and daytime sleepiness fades or
disappears.
Many studies have shown that this treatment determines improvement of the medical and
psychological status. However, the rate of non-adherence to treatment reported in the
literature is about 46-83%, considering as adherence the use of CPAP for at least 4 hours
per night. A recent study has shown that CPAP used as a single treatment in patients with
OSA and depression, has reduced the depressive symptoms but in a significant percentage of
patients (42%), the depressive symptoms remained unchanged or worsened. At the present time
have not been published, to our knowledge, studies concerning the effectiveness of the
combined treatment of CPAP and psychological support on the mood and on the quality of life
OSA patients.
Therefore the aim of this study is to evaluate the effects of the combined treatment with
CPAP and psychological intervention with cognitive behavioural therapy on the mood and on
the quality of life of OSA patients.
Primary endpoint The primary endpoint of the study is the evaluation of the mood tone,
measured before and 12 weeks after the start of treatment through the administration of
the13-item self-rated Pichot depression scale (QD2A). Each subject will be assigned to one
of the following categories:"absence of alterations in mood" or "presence of mood
disorders," according to the test result (score <7 or score ≥7).
The subjects in which, for whatever reason, the QD2A test after 12 weeks of treatment will
not be available, will be considered failures, and will be assigned to the class "presence
of mood disorders." Secondary endpoint Evaluation of adherence to CPAP treatment,
considering as adherence the use of CPAP, during the observation period, for at least 4
hours per night.
After 12 weeks of treatment, each patient will be classified as "adherent" or "non-adherent"
to the treatment itself. The subjects in whom, for whatever reason, after 12 weeks of
treatment, the total number of hours of use of CPAP will not be available, will be assigned
to the class of "non-adherent".
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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