0577 Effect of Continuous Positive Airway Pressure on Quality of Life Measures in Moderate to Severe Obstructive Sleep Apnea: Sleep Apnea Stress Study Randomized Controlled Trial
Bibliographic record
Abstract
Although there has been recent emphasis on importance of patient reported outcomes (PRO) in obstructive sleep apnea (OSA), few studies have systematically examined treatment impact. We leveraged a randomized clinical trial to examine the hypothesis that continuous positive airway pressure (CPAP) improves PRO in moderate to severe OSA. Sleep Apnea Stress Study (SASS) is a single-center, parallel, randomized controlled trial (RCT) designed to examine impact of 2-month CPAP versus sham in moderate to severe OSA (Apnea Hypopnea Index>15) on cardiovascular measures (ClinicalTrials.govNCT00607893). Collected quality of life measures included Calgary SAQLI (Sleep Apnea Quality of Life Index), FOSQ (Functional Outcome of Sleep Questionnaire), SF36 (Short Form Health Survey), ESS (Epworth Sleepiness Scale), PANAS (Positive and Negative Affect Schedule), CESD (Center for Epidemiological Studies Depression). Linear regression models were used to compare change between CPAP and sham groups (and compliant/non-compliant CPAP subgroups) adjusted for baseline measures and follow-up compliance. Subset analysis was performed in patients who had “abnormal” baseline PRO. The overall analytic sample was:age51.01+/-11.7yrs, 52.3%Caucasian, 53.7%males, body mass index of 37.2+/-8.1kg/m2. Of 153 participants, 74 were randomized to sham group and 75 to CPAP. None of the PRO showed difference in CPAP versus sham CPAP, although trend for statistical significance was observed for ESS (CPAP:-2.25:-3.18,-1.33 versus sham CPAP:-1.07:-1.98,-0.17, p=0.074). Those compliant with CPAP versus non-compliant demonstrated greater improvement in ESS when compared to sham CPAP[CPAP adherent-least square mean(95%confidence interval)-3.0(-4.3,-1.7)vs. CPAP non-adherent-1.1(-2.3,-0.1)vs.sham CPAP-1.1(-1.95,-0.3), p=0.045]. CPAP versus sham had more improvement in SF-36 Physical component scale(p=0.03)in those with baseline SF-36 Physical Component Scale<45.7(median). In this clinical trial with relatively normal baseline range of PRO, no statistically significant improvement in PRO was observed except for ESS in those compliant with CPAP. Furthermore, exploratory subgroup analyses showed greater physical component SF-36 improvement in those with baseline lower scores. This study is supported by National Heart, Lung and Blood Institute, K23HL079114, National Institutes of Health (NIH), NCRR UL1RR024989.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.022 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".