CPAP therapy in OSA patients: effect of type D personality on symptom burden.

STUDY OBJECTIVES: To determine the effect of CPAP therapy on symptom burden in OSA patients with and without type D personality. METHODS: OSA patients eligible for CPAP treatment filled out the DS-14, BFI-2, HADS, SF-36, PSQI, ISI, ESS, SSS, FAS and CIS questionnaires. These were repeated at 3, 6 and 18mo after CPAP initiation. At each visit, adherence and residual AHI were collected from the CPAP device. RESULTS: Of the 605 patients who initiated CPAP treatment for moderate to severe OSA and were included in the study, 384 patients showed optimal CPAP treatment (residual AHI <5/hour combined with an adherence of ≥ 4h/night) at visit 1, and 272 patients completed all study visits with optimal CPAP treatment during the entire 18 months follow-up period. CPAP therapy had a positive impact on fatigue, anxiety, depression, health perception, sleepiness, sleep quality, and insomnia severity at 3 months, with an additional improvement of the latter 3 symptoms at 6 months. Despite these improvements, OSA patients with type D personality remained significantly more symptomatic at 18 months. CONCLUSION: While OSA patients benefit from CPAP treatment, irrespective of type D personality, the patients with type D do show more residual OSA symptoms than their non-type D counterparts. These results suggest close and pro-active management could be relevant in patients with OSA and type D personality.