Obstructive sleep apnea symptoms beyond sleepiness and snoring: effects of nasal APAP therapy

The purpose of this study was to evaluate the prevalence and assess the response to nasal automatic positive airway pressure (APAP) therapy of less typical symptoms in patients diagnosed with obstructive sleep apnea (OSA), like fatigue, gasping, nocturia, nocturnal sweating, morning headaches, heartburn, and erectile dysfunction. Ninety-eight male patients with moderate to severe OSA were included in the study (n = 98). In the beginning of the study, an overnight sleep study was performed to all subjects using a five-channel recording device. Patients started APAP therapy with pre-determined minimum and maximum pressures of 4 and 15 cmH(2)0, respectively. The total Sleep Disorders Questionnaire was answered by all subjects before and 6 months after APAP therapy. Questions 4, 18, 23, 25, 58, 88, and 148 were used in this study. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) 17.0 software. Subjects had a mean (SD) age of 55.1 (10.8) years and an average of 52.2 (21.4) apnea-hypopnea events per hour of sleep. At baseline, nocturia was the most prevalent symptom (38%), followed by nocturnal sweating (34%), gasping (30%), erectile dysfunction (25%), fatigue (23%), heartburn (15%), and morning headaches (10%). After 6 months of APAP therapy, a statistically significant reduction on the prevalence of all symptoms was observed, except for erectile dysfunction and morning headaches. The findings suggest that APAP therapy is effective in controlling the majority of OSA symptoms beyond sleepiness and snoring.