0536 Impact of Positive Airway Pressure Therapy on Clinical Outcomes in Older Veterans with Comorbid COPD and OSA: An Update

Autor: Danny Greig, Ruchi Rastogi, Jaskiran Bansal, Poonam Mishra, Abdullahi Ahmed, Lili Zhao, Andrew Mcconnell, Clete Kushida, Bradley Axelrod, Q Afifa Shamim-Uzzaman, Susmita Chowdhuri
Rok vydání: 2023
Předmět:
Zdroj: SLEEP. 46:A236-A236
ISSN: 1550-9109
0161-8105
Popis: Introduction Cognitive impairment in older Veterans is an independent predictor of subsequent mortality and disability. Pilot data indicate that patients with OSA-COPD Overlap Syndrome (OVS) may have reduced sleep quality, cognitive function and quality of life (QoL). However, there are no prior systematic studies evaluating treatment paradigms in patients with OVS. Our ongoing clinical trial is investigating whether positive airway pressure (PAP) therapy alleviates sleep disturbances, sleepiness, and improves cognitive function and QoL in older adults with OVS. Methods The design is a prospective parallel group randomized controlled trial in Veterans 60 years and older, with moderate-to-severe OSA with concomitant COPD (OVS). 225 eligible participants will be randomized to two treatment groups (PAP and conservative care) in 2:1 ratio for a duration of 6 months. Participants on the conservative care arm are required to follow good sleep habits and sleep hygiene, and on the PAP arm, in addition, are required to be adherent to PAP treatment (CPAP or Bilevel PAP, as required). Sleep questionnaires are administered to evaluate sleepiness, sleep quality, and general and disease specific QoL. Cognitive function is evaluated using Trail Making Test Part A and B, Paced Auditory Serial Addition Test, Stroop Task, Digit Coding, Hopkins Verbal Learning Test-R, Weschler Abbreviated Scale Intelligence II, Weschler Memory Scale IV, and Psychomotor Vigilance Test, respectively. All tests are administered at baseline visit, 3 months, and 6 months. Results In year-2 of the study, we have screened 7878 Veterans, enrolled 137 participants, randomized 34 participants (31 males, 3 females; age: 70.7±6.6 years, BMI: 29.6±6.7 kg/m2, AHI: 47±22 events/hr, spirometry FEV1: 60.8±11.7% predicted, arterial blood gas (n=22) pCO2:41.2 ±3.6 mmHg, ESS: 1.9 ±2.4); 15 have completed the study per the protocol. Analysis of data will be completed at the end of the RCT. Conclusion Our research seeks to systematically study the effects of treating a novel target (OVS) to maximize daytime function and QoL, while also providing a framework for early treatment of mild cognitive impairment in vulnerable older Veterans. Support (if any) VHA RR&D Merit Award # 1I01RX003124-01
Databáze: OpenAIRE
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