Community-based intervention for obstructive sleep apnea in the general population: a randomized controlled trial

Abstract

Abstract Study Objectives To investigate the engagement and health outcomes of community-based intervention for obstructive sleep apnea (OSA) in the general population. Methods We conducted a 3-month randomized controlled trial in two communities in southern China. We initially screened the general population for high-risk OSA and further diagnosis using home sleep testing. Eligible participants were randomly (1:1) assigned to either a control or continuous positive airway pressure-based integrated intervention group. The primary outcomes were multimodal indicators reflecting health outcomes, including health-related quality of life (Short Form-36 [SF-36]), sleep-related symptoms, and cardiometabolic risk. Results Of the 2484 participants screened, 1423 identified as having high-risk OSA were considered for telephone invitations to participate in the trial. Of these, 401 participants responded positively (28.2%), 279 were diagnosed with OSA, and 212 were randomized. The intervention significantly improved several domains of SF-36, including physical functioning (intergroup difference, 2.8; p = .003), vitality (2.3; p = .031), and reported health transition (6.8; p = .005). Sleep-related symptoms, including Epworth Sleepiness Scale (−0.7; p = .017), Fatigue Severity Scale (−3.0; p = .022), Insomnia Severity Index (−1.8; p < .001), and Pittsburgh Sleep Quality Index (−0.7; p = .032), also showed significant improvements. Although the intervention did not significantly alter glycolipid metabolism, ventricular function, or cardiac structural remodeling, it achieved a significant reduction in systolic (−4.5 mmHg; p = .004) and diastolic blood pressure (BP; −3.7 mmHg; p < .001). Conclusions Community-based intervention for previously undiagnosed OSA in the general population yielded improvements in health-related quality of life, sleep-related symptoms, and BP. However, engagement in the intervention program was low. Clinical Trial Registration “Community Intervention Trial for OSA”; URL: https://www.chictr.org.cn/showprojEN.html?proj=144927; Trial identification number: ChiCTR2100054800.