CPAP for the over 65s with obstructive sleep apnoea syndrome

Continuous positive airway pressure (CPAP) use for middle-aged patients with symptomatic moderate-severe obstructive sleep apnoea (OSA) has a clear evidence base showing patient benefit and cost effectiveness. Despite many clinicians using CPAP in older patients, specific evidence for this practice is limited. McMillan et al (Lancet Respir Med 2014. pii: S2213-2600(14)70172-9) have reported the results of the PREDICT trial (CPAP in older people with OSA syndrome). This UK trial involved 14 recruiting sites, where consecutive patients aged 65 years or above with an Oxygen Desaturation Index of >7.5/h and an Epworth Sleepiness Scale >8 were randomised to receive either CPAP therapy (autoset device) with best supportive care, or best supportive care alone, for 12 months. Two hundred and seventy-eight patients were recruited with 140 patients allocated to CPAP. The mean age across both treatment groups was 71 (SD 4.6) years, Oxygen Desaturation Index (ODI) 28.7 (19.1) and Epworth Sleepiness Scale (ESS) 11.6 (3.7). At 3 months, the ESS was …