0538 CPAP TREATMENT IMPROVES LAPSE COUNT ON PSYCHOMOTOR VIGILANCE TASK TESTING IN PATIENTS WITH OSA: RESULTS OF A PILOT STUDY

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Obstructive sleep apnea (OSA) is known to cause sleep fragmentation and hamper daytime performance. While patients with OSA often report a subjective improvement in daytime alertness with continuous airway pressure (CPAP) treatment, it is unclear if such therapy produces an objective increase in daytime vigilance. As part of a larger study, we compared the number of lapses (lack of response to visual stimulation for 500 msecs or longer) during psychomotor vigilance task (PVT) testing in patients with OSA before and after CPAP therapy to determine whether there was improvement in vigilance. Sixty-nine adult patients (72.5% male; mean age 49.9 years, SD ±12.3) determined to have OSA by virtue of an apnea-hypopnea index [AHI] >5/hr on their diagnostic sleep study (mean AHI 41.9/hr, SD ±37.1) performed a ten-minute PVT test before and after adequate use of CPAP for a minimum of one month. Adequate CPAP use was defined as compliance of more than 4 hours per night for a minimum of 70% of nights, averaged over the preceding 30 days, and with an average residual AHI of <5/hr during that time period. The number of lapses before and after CPAP treatment was recorded and compared. A paired t-test was used to look for a significant difference in the mean number of lapses. There was a small but significant improvement in the mean number of lapses on PVT testing (1.9 post-treatment vs. 2.9 pre-treatment) in patients with OSA treated adequately with CPAP for at least a month (p=0.03). Our pilot data suggest that treatment with CPAP improves daytime vigilance in patients with OSA. This has important implications in the management of patients with OSA, particularly those in whom sustained concentration is an essential employment skill, such as commercial drivers. Larger studies that explore the best predictors of improvement in PVT performance with CPAP treatment in patients with OSA are awaited. N/A.