Clinical Significance of the Findings
sleepiness, OSA, hypertensive
EXCESSIVE SLEEPINESS
It is widely accepted that a dose-response relationship exists between the hours of CPAP use per night and a range of clinical outcomes [A study examining the relationship between the average hours of CPAP use per night and sleepiness as well as daily functioning showed that among the participants who had excessive sleepiness before the start of CPAP treatment, those whose excessive sleepiness resolved with CPAP treatment had, on average, approximately 1 hour more CPAP use per night than those whose excessive sleepiness remained (5.1 vs 4.0 hours per night for self-reported sleepiness and 5.1 vs 3.9 hours per night for objective sleepiness) [Similar results were found in another study for self-reported sleepiness but not for objective sleepiness and daily functioning [CPAP adherence has also been associated with improvements in cardiovascular symptoms. The findings of several studies have shown a positive relationship between the average hours of CPAP use per night and blood pressure reduction in hypertensive patients with OSA starting CPAP treatment [There is increasing evidence of a positive dose-response relationship between CPAP adherence and clinical outcomes. Although the assessment of clinical impact goes beyond the scope of this study, the impact of the intervention on CPAP adherence (a difference of 56.4 minutes on average throughout the 90-day study period and 81.3 minutes at study day 90) is comparable with the CPAP adherence differences shown to have clinical significance.