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

To determine the effect of CPAP therapy on symptom burden in OSA patients with and without type D personality.

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.

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.

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.