A80-1-07 Long-term Symptom, Psychological, and Functional Outcomes in Patients With Obstructive Sleep Apnea and Excessive Daytime Sleepiness Treated With Cpap: 24-month Results From the Hypnosa Cohort
A Roncero Lázaro, O Mediano, I Cano-Pumarega, C Ruiz-Martínez, M Cristeto, M Aguado Agudo, J Lázaro, L Pérez Bozalongo, P Vicente, C Egea, C Pía, J Ullate Mora, L Pozuelo Sánchez, S Romero, P Resano Barrio, M Mosteiro Anon, F Barbe, M Dolores, C Muñoz Peláez, I Podzamczer, A M Fortuna, M González, T Diaz de Teran, M Dalmases, J García, A Alonso-Fernández, M de la Peña Bravo, V Cabriada-Nuño, A Urrutia Gajate, N Grau Sanmartí, M Minoves Farrés, M Cano Aguirre, N Salord, E Fontanilles, C Castelló Faus, A Ramos Pinedo, I Hontanaya Navas, M Lores Gutiérrez, B Arias Arcos, B Jara Chinarro, E Ávalos, M Martín Carpi, R Catala Perez, N Boukichou, M Sanchez De La TorreAbstract
Aims
To characterize the long-term physiological, symptomatic, psychological, and functional outcomes in patients with obstructive sleep apnea (OSA) and excessive daytime sleepiness (EDS) treated with continuous positive airway pressure (CPAP), and to identify residual limitations despite optimal therapy.
Methods
Prospective multicenter cohort including 616 adults with OSA and EDS assessed at baseline, 6, 12, and 24 months. Evaluations included polysomnography (apnea-hypopnea index [AHI], CT90, mean SpO₂), Epworth Sleepiness Scale (ESS), EuroQol-5D (EQ-5D), Functional Outcomes of Sleep Questionnaire (FOSQ), Hospital Anxiety and Depression Scale (HADS), and CPAP adherence. Longitudinal descriptive analyses were performed.
Results
Mean age was 55.6 ± 11.5 years; 65.6% were male. At baseline, most patients had severe OSA (mean AHI 39.5 ± 25.9/h) with significant hypoxic burden (CT90 21.7 ± 23.1%) and marked clinical impairment (ESS 10.9 ± 5.5; HADS 12.1 ± 7.2; FOSQ 92.1 ± 24.4; EQ-5D 71.0 ± 16.9). CPAP treatment resulted in early and statistically significant improvement across all symptomatic, psychological, and functional domains at 6 months (ESS 7.95 ± 4.6; HADS 4.17 ± 6.6; FOSQ 100.1 ± 21.3; all p < 0.001), together with marked physiological correction (AHI 3.2 ± 5.0/h; CT90 0.5%; mean SpO₂ 95%). Improvements were sustained at 12 months (ESS 7.19 ± 4.2; HADS 2.04 ± 4.8; FOSQ 101.5 ± 21.0), with excellent adherence (90.8% of patients using CPAP >4 h/night). Despite overall recovery, selected functional domains—particularly general activity—showed incomplete improvement, despite optimal physiological correction. Preliminary 24-month data, although limited, suggested maintenance of symptomatic and functional benefit.
Conclusions
In patients with OSA and EDS, CPAP provides rapid and sustained improvements in physiological, symptomatic, psychological, and functional outcomes over long-term follow-up with excellent adherence. However, persistent functional limitations in selected domains suggest that CPAP alone may be insufficient to fully restore daily functioning in this phenotype, supporting the need for comprehensive, multidimensional follow-up strategies and potential adjunctive interventions beyond CPAP monotherapy.
This abstract is funded by: SEPAR, SES, BIOPROJET,