Neurology

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Review: continuous positive airway pressure devices are effective and cost-effective for obstructive sleep apnoea
Evidence-Based Medicine, 10/22/09

Chatterjee AB – CPAP improved subjective sleepiness and ability to stay awake more than placebo or usual care but did not differ from dental devices; treatment effect was greatest in patients with the most severe symptoms. Compared with placebo or usual care, CPAP reduced daytime mean arterial pressure (by 2.1 mm Hg, 95% CI 0 to 4.3; 6 RCTs, n = 309) but not daytime systolic or diastolic BP (7 RCTs, n = 220), measured by ambulatory monitoring. Cost–effectiveness of CPAP (based on a hypothetical cohort of men aged 50 y; using a lifetime time horizon; and including costs for treatment, cardiovascular disease events, and traffic accidents) was estimated at £2500 per quality–adjusted life–year (QALY) compared with usual care and £3900 per QALY compared with dental devices. Continuous positive airway pressure devices reduce symptoms of sleepiness and are cost–effective for obstructive sleep apnoea–hypopnoea syndrome.

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