Continuous Positive Airway Pressure to Improve Milder Obstructive Sleep Apnea

Inclusion Criteria

• Newly diagnosed with OSA on overnight polysomnogram (PSG) with RDI between 5 and 30
• Score of greater than 11 on the Epworth Sleepiness Scale (ESS) on two administrations of the instrument (performed at prescreening and screening), each completed on a different day to avoid sporadic values and confirm the presence of excessive daytime sleepiness
• Stable medical history and no change in medications, including hypertension medications, in the 3 months prior to study entry
• Stable psychiatric history and no change in psychotropic medications in the 3 months prior to study entry
• Has access to a telephone

Exclusion Criteria

• Diagnosis of another sleep disorder in addition to OSA based on PSG, e.g., periodic limb movement disorder (greater than 10 limb movements per hour of sleep with arousal); central sleep apnea (greater than 5 or more central apneas); insomnia; sleep hypoventilation syndrome; or narcolepsy
• Previous treatment for sleep apnea with nasal CPAP, oral appliance, home oxygen therapy, uvulopalatopharyngoplasty, tracheotomy, or other surgery for OSA
• Oxygen or bi-level CPAP required for treatment of OSA
• Unable to return for study instructions or follow-up testing
• Medically unstable condition (e.g., heart attack, congestive heart failure, Cheyne-Stokes breathing, unstable angina, uncontrolled thyroid disease, unstable diabetes, depression or psychosis, ventricular arrhythmias, cirrhosis, or recently diagnosed cancer) in the 3 months prior to study entry
• Regular use (greater than 3 times per week) of sedative, hypnotic, or alerting medications (such as Modafinil) in the 3 months prior to study entry
• Chronic nasal congestion that would prevent the use of a nasal mask, in the 3 months prior to study entry
• History of automobile accidents due to excessive daytime sleepiness
• Employed in transportation-related safety sensitive occupation such as an airline pilot, truck driver, or train engineer
• Night shift worker regularly experiencing jet lag, or a history of irregular work schedules in the 6 months prior to study entry
• Regular use of alcohol as determined by answering yes to one or more of the questions on the CAGE questionnaire (i.e., alcohol dependent)
• Recent or recurring history of substance abuse leading to tolerance or dependence
• Pregnant; women must either be postmenopausal or confirmed not pregnant by a urine pregnancy test
• Unable to perform study tests, e.g., inability to communicate verbally; inability to write and read in English; less than a 5th grade reading level (evaluated using Flesch-Kincaid assessment); visual impairment; hearing impairment; cognitive impairment (e.g., previous head injury); or upper extremity motor deficit (e.g., previous stroke or spinal cord injury)
• Residing with an individual who is currently using CPAP treatment