Obstructive Sleep Apnea Treatment to Improve Cardiac Rehabilitation

Obstructive Sleep Apnea Treatment to Improve Cardiac Rehabilitation

This is a randomized clinical trial in U.S. Veterans to evaluate the impact of treatment for obstructive sleep apnea (OSA) on the effectiveness of cardiac rehabilitation, including impact on exercise capacity, disability, and quality of life.

Obstructive sleep apnea (OSA) is a highly prevalent condition in patients with coronary heart disease and is associated with impaired exercise performance, functional limitation and reduced health-related quality of life. The investigators hypothesize that identification and treatment of OSA in patients undergoing cardiac rehabilitation will improve the response to rehabilitation. The proposed study will test this hypothesis using a parallel group, randomized, clinical trial comparing OSA treatment with continuous positive airway pressure (CPAP) to an educational control group in patients undergoing cardiac rehabilitation who screen positive for previously undiagnosed OSA.

Inclusion Criteria:

• Veterans referred for cardiac rehabilitation at the VA Boston Healthcare System.
• Moderate to severe OSA (AHI >15) on home sleep testing.

Exclusion Criteria:

• Dangerous levels of sleepiness (Epworth Sleepiness Scale score >16 or a report of falling asleep at the wheel of a car within the past 2 years).
• Physical limitation precluding exercise testing.