Obstructive sleep apnoea in older people

Obstructive sleep apnoea (OSA) is common and the prevalence increases with age. When OSA leads to sleep disruption and excessive daytime sleepiness, it is referred to as obstructive sleep apnoea syndrome (OSAS). The aim of this thesis was to investigate the consequences of OSAS in older people (˃ 65 years) and the effect of continuous positive airway pressure (CPAP) therapy. CPAP is the treatment of choice in moderate to severe OSAS in middle aged people. However, there is a paucity of evidence on the therapeutic and economic benefits of CPAP in older people with OSAS. The two studies in this thesis aimed to address this by comparing outcomes in older people with OSAS before and after treatment with CPAP. The first study presented is the thesis is the PREDICT trial; a multicentre randomised controlled trial of CPAP in older people with OSAS. The trial studied the clinical efficacy of CPAP after 3 months, while determining the cost effectiveness of treatment over 12 months. The results of the trial showed that CPAP was an effective treatment for reducing excessive daytime sleepiness by -2.1 (95%CI -3.0 to -1.3); p